Healthcare Provider Details

I. General information

NPI: 1023420395
Provider Name (Legal Business Name): HERMELINDA TERRONES NAJERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 05/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S SALTA ST 11
SANTA ANA CA
92704-5650
US

IV. Provider business mailing address

2500 SOUTH SALTA ST APT11
SANTA ANA CA
92704
US

V. Phone/Fax

Practice location:
  • Phone: 714-360-7163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number68759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: