Provider Demographics
NPI:1578437679
Name:DOLAN, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TRINITY ST
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CA
Mailing Address - Zip Code:95570-9517
Mailing Address - Country:US
Mailing Address - Phone:707-677-3631
Mailing Address - Fax:
Practice Address - Street 1:300 TRINITY ST
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CA
Practice Address - Zip Code:95570-9517
Practice Address - Country:US
Practice Address - Phone:707-677-3631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach