Delapedraja, Kyra Marie Dougherty
Delapedraja, Kyra Marie Dougherty is an individual health care provider with primary practice located at 15400 Los Gatos Blvd , Los Gatos CA 95032-2502. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Delapedraja, Kyra Marie Dougherty can be contacted via phone (408) 523-3640.Contact Information
Primary practice address
15400 Los Gatos Blvd
Los Gatos CA 95032-2502
Phone: (408) 523-3640
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | NP95002321 | California |
Profile Details
| NPI number | 1164666442 |
|---|---|
| LBN Legal business name | Delapedraja, Kyra Marie Dougherty |
| Credentials | Pediatric Nurse Practitioner (PNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 30th, 2009 |
| Last updated | Mar 4th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164666442 | NPPES |
| Colorado | MEDICAID | 22678522 |
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