Individual
KATHLEEN MAE DELOS REYES ABUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
859 N WILTON PL, LOS ANGELES, CA 90038-4057
(323) 470-9304
Mailing address
859 N WILTON PL, LOS ANGELES, CA 90038-4057
(323) 470-9304
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
30858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30858
—
CA
05
—
729
—
CA
Enumeration date
02/24/2017
Last updated
04/19/2019
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