Healthcare Provider Details

I. General information

NPI: 1871279422
Provider Name (Legal Business Name): BETTINA PASAMBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 S MAIN ST
SALINAS CA
93901-2205
US

IV. Provider business mailing address

1211 S MAIN ST
SALINAS CA
93901-2205
US

V. Phone/Fax

Practice location:
  • Phone: 831-272-7921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: