Individual
RICARDO ERNESTO VAQUERANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDAEF
Contact information
Practice address
18308 SHERMAN WAY STE 1, RESEDA, CA 91335-4475
(818) 881-0404
(818) 881-7108
Mailing address
13982 STROUD ST, PANORAMA CITY, CA 91402-6516
(818) 674-1954
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
1579
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1579
AEF
CA
01
—
22
OA
CA
01
—
75121
RDA
CA
Enumeration date
02/20/2021
Last updated
02/20/2021
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