Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 11949 | CA |
NPI | 1073729760 |
---|---|
Provider Name | Paulina Jo Augusta Attebery |
First Address | South Pasadena, CA 91030-4050 |
Second Address | Los Angeles, CA 90057-2238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |