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General NPI Number Information
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NPI Number | 1447031083
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Entity Type | Individual
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Provider Name | DEANNAH DOUGLAS-MARSHALL
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Gender | Female
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 4822 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90062-2324
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Country | US
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Telephone | 562-688-4994
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Fax |
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Provider Business Mailing Address
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Address Line | 5250 W CENTURY BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90045-5946
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Country | US
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Telephone |
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 711368
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | E2438910
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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