Healthcare Provider Details

I. General information

NPI: 1699072439
Provider Name (Legal Business Name): ADRIANA ELIZABETH NARANJO RDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 LAKEWOOD BOULEVARD
DOWNEY CA
90241
US

IV. Provider business mailing address

10501 LAKEWOOD BOULEVARD
DOWNEY CA
90241
US

V. Phone/Fax

Practice location:
  • Phone: 562-862-2341
  • Fax: 562-861-8350
Mailing address:
  • Phone: 562-862-2341
  • Fax: 562-861-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License NumberRDA60784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: