Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 27974 | CA |
Y | 124Q00000X | Dental Hygienist | 810 | CA |
NPI | 1033622238 |
---|---|
Provider Name | Rhiannon Cordeiro |
First Address | San Diego, CA 92139-2817 |
Second Address | San Diego, CA 92139-2817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2017 |
Last Update Date | 06/08/2021 |