Individual
CARLA CHERI LASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REG DENTAL HYGIENIST
Contact information
Practice address
700 ADELINE ST, OAKLAND, CA 94607-2608
(510) 835-9610
Mailing address
700 ADELINE ST, OAKLAND, CA 94607-2608
(510) 835-9610
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
27300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306967021
—
CA
Enumeration date
06/05/2018
Last updated
06/05/2018
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