Basic Information
| Provider Information | |||||||||
| NPI: | 1477791572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DONOHUE | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 205 LOS AGUAJES AVE APT L | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931013841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054504104 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2415 DE LA VINA ST | ||||||||
| Address2: | COTTAGE REHABILITATION HOSPITAL | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931053819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056877444 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2009 | ||||||||
| LastUpdateDate: | 01/27/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WR0400X | 481545 | CA | Y | Nursing Service Providers | Registered Nurse | Rehabilitation |
No ID Information.