Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 25037 | CA |
NPI | 1053810598 |
---|---|
Provider Name | Tamara Lindley |
First Address | San Diego, CA 92128 |
Second Address | San Diego, CA 92128-9212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2018 |
Last Update Date | 15/11/2021 |