Provider Demographics
NPI:1124304100
Name:DOU, XIAOLI (LVN)
Entity type:Individual
Prefix:MRS
First Name:XIAOLI
Middle Name:
Last Name:DOU
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 WILLIAMSBURG RD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-1423
Mailing Address - Country:US
Mailing Address - Phone:714-553-8573
Mailing Address - Fax:
Practice Address - Street 1:2767 WILLIAMSBURG RD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-1423
Practice Address - Country:US
Practice Address - Phone:714-553-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-22
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN162541164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse