Healthcare Provider Details

I. General information

NPI: 1235051707
Provider Name (Legal Business Name): VERONICA DE LOURDES RIVERO TESTAMARCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11850 SKYLARK CIR # 3204
WHITTIER CA
90606-1330
US

IV. Provider business mailing address

11850 SKYLARK CIR # 3204
WHITTIER CA
90606-1330
US

V. Phone/Fax

Practice location:
  • Phone: 509-788-5777
  • Fax:
Mailing address:
  • Phone: 509-788-5777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS112586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: