Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 58523 | CA |
NPI | 1003093691 |
---|---|
Provider Name | Dr. Helen Thu Trinh |
First Address | Petaluma, CA 94954-6559 |
Second Address | Petaluma, CA 94954-6559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2008 |
Last Update Date | 10/01/2012 |