=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285612424
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOLORES ANN WEST RN, NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2416 W SHAW AVE SSUITE 106
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93711-3303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-438-1777
-----------------------------------------------------
Fax | 559-432-4533
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5490 N WEST AVE APT 103
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93711-2952
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-435-5447
-----------------------------------------------------
Fax | 559-432-4533
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 8151
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------