Healthcare Provider Details

I. General information

NPI: 1831994649
Provider Name (Legal Business Name): CATHERINE M OLANDER RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHY M OLANDER RDHAP, BS

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4153 SERENA AVE
CLOVIS CA
93619-0514
US

IV. Provider business mailing address

4153 SERENA AVE
CLOVIS CA
93619-0514
US

V. Phone/Fax

Practice location:
  • Phone: 209-676-9375
  • Fax:
Mailing address:
  • Phone: 209-676-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number35550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: