Healthcare Provider Details

I. General information

NPI: 1356205918
Provider Name (Legal Business Name): HANNAH GARRETT RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18144 SECO ST
JAMESTOWN CA
95327-9498
US

IV. Provider business mailing address

PO BOX 535
JAMESTOWN CA
95327-0535
US

V. Phone/Fax

Practice location:
  • Phone: 209-984-4820
  • Fax: 209-984-4825
Mailing address:
  • Phone: 209-984-4820
  • Fax: 209-984-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number37928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: