Provider Demographics
NPI:1316451487
Name:DRURY-KLEIN, LADONNA MARIE (RDA)
Entity type:Individual
Prefix:MRS
First Name:LADONNA
Middle Name:MARIE
Last Name:DRURY-KLEIN
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4995 GOLDEN FOOTHILL PKWY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9645
Mailing Address - Country:US
Mailing Address - Phone:916-358-3825
Mailing Address - Fax:916-358-3828
Practice Address - Street 1:4995 GOLDEN FOOTHILL PKWY
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9645
Practice Address - Country:US
Practice Address - Phone:916-358-3825
Practice Address - Fax:916-358-3828
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDA26274174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator