Skip Navigation

Provider Information for 1285896241

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1285896241

Calendar   Last Updated:  2009-08-05
  Certification Date: 


Name Value
NPI 1285896241
Enumeration Date 2008-06-30
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 28762 PRAIRE FALCON CT 2ND FLOOR
MURRIETA, CA 92563-7919
United States

Phone: 714-368-2077 | Fax: 714-368-2092
View Map External Link
Primary Practice Address 18285 COLLIER AVE SUITE B
LAKE ELSINORE, CA 92530-2786
United States

Phone: 951-471-0034 | Fax: 951-471-0166
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 56125