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General NPI Number Information
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NPI Number | 1144660499
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Entity Type | Individual
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Provider Name | ANNE TARLETON DOUGHERTY M.S.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 220 S PALISADE DR SUITE 201
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City | SANTA MARIA
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State | CA
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Zip | 93454-8902
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Country | US
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Telephone | 323-636-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 5327 ARGOS ST
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City | AGOURA HILLS
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State | CA
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Zip | 91301-3371
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Country | US
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Telephone | 323-636-6070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GC000492
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License Number State | CA
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