Healthcare Provider Details

I. General information

NPI: 1215854328
Provider Name (Legal Business Name): ANETTE VAZQUEZ TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 N VERMONT AVE
DINUBA CA
93618-3230
US

IV. Provider business mailing address

618 N VERMONT AVE
DINUBA CA
93618-3230
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-1177
  • Fax:
Mailing address:
  • Phone: 559-624-1177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number106997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: