Provider Demographics
NPI:1356789978
Name:TAPAOAN, DORATHEA MARILYNN
Entity type:Individual
Prefix:MRS
First Name:DORATHEA
Middle Name:MARILYNN
Last Name:TAPAOAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DORI
Other - Middle Name:MARILYNN
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PMB # 146 171 BRANHAM LN
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136
Mailing Address - Country:US
Mailing Address - Phone:910-495-4743
Mailing Address - Fax:
Practice Address - Street 1:171 BRANHAM LN
Practice Address - Street 2:PMB # 146 SUITE 10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-2378
Practice Address - Country:US
Practice Address - Phone:910-495-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health