# DENTAL HYGIENE PRACTICE OF SHANAY FRY, RDHAP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245604214
- **Authorized official:** MRS. SHANAY LYNN FRY RDHAP (OWNER)
- **Authorized official phone:** (949) 702-6306

## Contact information

- **Practice address:** 13646 ABANA DR, CERRITOS, CA 90703-1003
- **Practice address phone:** (949) 702-6306
- **Mailing address:** 13646 ABANA DR, CERRITOS, CA 90703-1003
- **Mailing address phone:** (949) 702-6306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 587 | CA | — |
| 310400000X | Assisted Living Facility | 587 | CA | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 587 | CA | — |
| 314000000X | Skilled Nursing Facility | 587 | CA | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 587 | CA | — |

## Other

- **Enumeration date:** 11/13/2015
- **Last updated:** 11/13/2015