Provider Demographics
NPI:1669170056
Name:ZUOFA, DOUBARA JESSICA
Entity type:Individual
Prefix:DR
First Name:DOUBARA
Middle Name:JESSICA
Last Name:ZUOFA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 APPLEWOOD DR APT 518
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-6483
Mailing Address - Country:US
Mailing Address - Phone:470-406-8935
Mailing Address - Fax:
Practice Address - Street 1:5204 SOPHIA DOWN CT
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-3002
Practice Address - Country:US
Practice Address - Phone:470-406-8935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251J00000X, 372600000X, 253Z00000X
GA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide