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General NPI Number Information
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NPI Number | 1730483710
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Entity Type | Individual
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Provider Name | JUDITH RENEE BROWN RDHAP
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Gender | Female
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 923 LA JOLLA AVE
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City | CLOVIS
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State | CA
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Zip | 93619-8951
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Country | US
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Telephone | 559-331-4879
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Fax | 559-765-4262
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Provider Business Mailing Address
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Address Line | 923 LA JOLLA AVE
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City | CLOVIS
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State | CA
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Zip | 93619-8951
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Country | US
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Telephone | 559-331-4879
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Fax | 559-765-4262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | RDHAP 322
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | RDHAP322
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License Number State | CA
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