Provider Demographics
NPI:1992977326
Name:GRIEGO, DOROTHY JEANNE (FNPC)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:JEANNE
Last Name:GRIEGO
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:DEE DEE
Other - Middle Name:
Other - Last Name:GRIEGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNPC
Mailing Address - Street 1:1523 W AVENUE J
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2819
Mailing Address - Country:US
Mailing Address - Phone:661-945-2221
Mailing Address - Fax:661-945-0831
Practice Address - Street 1:1523 W AVENUE J
Practice Address - Street 2:SUITE 7
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2819
Practice Address - Country:US
Practice Address - Phone:661-945-2221
Practice Address - Fax:661-945-0831
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP6736364SF0001X
CA6736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health