Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | CA |
NPI | 1275772998 |
---|---|
Provider Name | Erika Valdovino0s |
First Address | South Gate, CA 90280-5031 |
Second Address | South Gate, CA 90280-5031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2009 |
Last Update Date | 19/02/2009 |