Provider Demographics
NPI:1144633967
Name:WENN, AVIRA (CD(DONA))
Entity type:Individual
Prefix:
First Name:AVIRA
Middle Name:
Last Name:WENN
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40676A OLD THREE RIVERS RD
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:CA
Mailing Address - Zip Code:93271-9732
Mailing Address - Country:US
Mailing Address - Phone:559-623-3291
Mailing Address - Fax:
Practice Address - Street 1:40676A OLD THREE RIVERS RD
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:CA
Practice Address - Zip Code:93271-9732
Practice Address - Country:US
Practice Address - Phone:559-623-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula