Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | HAP 483 | CA |
NPI | 1043638364 |
---|---|
Provider Name | Mrs. Catherine Zendejas |
First Address | Fresno, CA 93722-2291 |
Second Address | Fresno, CA 93722-2291 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 03/04/2014 |