Healthcare Provider Details

I. General information

NPI: 1891137964
Provider Name (Legal Business Name): ADRIANA GONZALEZ RDHAP, RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 01/19/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 LINCOLN AVE
LANCASTER CA
93535
US

IV. Provider business mailing address

1310 LINCOLN AVE
LANCASTER CA
93535-4279
US

V. Phone/Fax

Practice location:
  • Phone: 661-902-1488
  • Fax:
Mailing address:
  • Phone: 661-902-1488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: