MEDICARE: DOLORA DOSSI PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY29332	CA

General Provider Information

NPI Number	:	1508267824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOLORA DOSSI PSYD

Provider Business Mailing Address
First Line	:	11920 YANKEE HILL RD
Second Line	:
City	:	COLUMBIA
State	:	CA
Zip	:	95310-9703
Country	:	US
Telephone Number	:	209-964-9564
Fax Number	:

Provider Business Practice Location Address
First Line	:	11920 YANKEE HILL RD
Second Line	:
City	:	COLUMBIA
State	:	CA
Zip	:	95310-9703
Country	:	US
Telephone Number	:	209-964-9564
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2014
Last Update Date	:	09/27/2017

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Directions to “ DOLORA DOSSI PSYD” Practice Location

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