Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 19221 | CA |
N | 126800000X | Dental Assistant | 42739 | CA |
NPI | 1093117780 |
---|---|
Provider Name | Heather Saiki |
First Address | Redding, CA 96003-8685 |
Second Address | Redding, CA 96003-8685 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2014 |
Last Update Date | 24/09/2014 |