Healthcare Provider Details

I. General information

NPI: 1942899224
Provider Name (Legal Business Name): YVETTE JEAN WARREN RDHEF, AP, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36977 PARK AVE
BURNEY CA
96013-4067
US

IV. Provider business mailing address

36977 PARK AVE
BURNEY CA
96013-4067
US

V. Phone/Fax

Practice location:
  • Phone: 530-335-3651
  • Fax:
Mailing address:
  • Phone: 530-335-3651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License NumberAEF236
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH19568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: