Healthcare Provider Details

I. General information

NPI: 1902711518
Provider Name (Legal Business Name): JOEL PAELMO OLIQUIANO RDHAP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8644 SUNNYBRAE DR
SACRAMENTO CA
95823-6934
US

IV. Provider business mailing address

8644 SUNNYBRAE DR
SACRAMENTO CA
95823-6934
US

V. Phone/Fax

Practice location:
  • Phone: 510-761-4634
  • Fax:
Mailing address:
  • Phone: 510-761-4634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberHAP1251
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: