Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | PSY 18641 | CA |
NPI | 1134288079 |
---|---|
Provider Name | Dr. Diana Marie Dorhofer |
First Address | Roseville, CA 95661-3700 |
Second Address | Roseville, CA 95661-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 03/01/2022 |