Individual
PAOLA RUBY TREJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
3951 AGNES AVE UNIT B, LYNWOOD, CA 90262-4418
(310) 866-0993
Mailing address
3951 AGNES AVE UNIT B, LYNWOOD, CA 90262-4418
(310) 866-0993
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
89136
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89136
—
CA
Enumeration date
09/15/2017
Last updated
07/21/2022
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