Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 75791 | CA |
NPI | 1336588516 |
---|---|
Provider Name | Mrs. Victoria Sarinana |
First Address | Inglewood, CA 90301-3231 |
Second Address | Los Angeles, CA 90007-2298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 20/06/2013 |