Individual
DIANN MARIE AZEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DIANN AZEVEDO
Contact information
Practice address
5875 PACIFIC STREET, C-1, ROCKLIN, CA 95677-3146
(916) 632-2554
Mailing address
5875 PACIFIC STREET, C-1, ROCKLIN, CA 95677-3146
(916) 632-2554
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP 15
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HO9342
DENTICAL
CA
Enumeration date
05/07/2007
Last updated
11/04/2015
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