1689800625 NPI number — PATRICIA MARY DONAHOE-ROMERO BSN, RN, PHN, CDE

Table of content: PATRICIA MARY DONAHOE-ROMERO BSN, RN, PHN, CDE (NPI 1689800625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689800625 NPI number — PATRICIA MARY DONAHOE-ROMERO BSN, RN, PHN, CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONAHOE-ROMERO
Provider First Name:
PATRICIA
Provider Middle Name:
MARY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BSN, RN, PHN, CDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DONAHOE
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSN, RN, PHN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689800625
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21391 VINTAGE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE FOREST
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92630-5827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-395-0205
Provider Business Mailing Address Fax Number:
949-586-1042

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 TECHNOLOGY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92618-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-923-3200
Provider Business Practice Location Address Fax Number:
949-923-3595
Provider Enumeration Date:
06/04/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WD0400X , with the licence number:  349497 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WH0200X , with the licence number: 349497 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WM0705X , with the licence number: 349497 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)