Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | RDA92216 | CA |
NPI | 1144865833 |
---|---|
Provider Name | Brenda Carcamo-Almendarez |
First Address | Palmdale, CA 93552-3612 |
Second Address | Palmdale, CA 93552-3612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2019 |
Last Update Date | 17/11/2019 |