Healthcare Provider Details

I. General information

NPI: 1336044361
Provider Name (Legal Business Name): CENTRAL VALLEY DENTAL HYGIENE PRACTICE OF N. RODRIGUEZ, RDHAP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 N MARKS AVE STE 102
FRESNO CA
93722-4555
US

IV. Provider business mailing address

1077 N WILLOW AVE STE 105
CLOVIS CA
93611-4411
US

V. Phone/Fax

Practice location:
  • Phone: 559-690-6651
  • Fax:
Mailing address:
  • Phone: 559-690-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateNULL

VIII. Authorized Official

Name: NANCY RODRIGUEZ
Title or Position: REGISTERED DENTAL HYGIENE
Credential: RDHAP
Phone: 559-690-6651