Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 25595 | CA |
NPI | 1013275395 |
---|---|
Provider Name | Kathy Tutino |
First Address | Oakland, CA 94601-2228 |
Second Address | Oakland, CA 94601-2228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 24/04/2012 |