Individual
YADIRA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
4141 STATE ST STE B11, SANTA BARBARA, CA 93110-1898
(805) 696-1002
Mailing address
152 PACIFIC AVE, PACIFIC GROVE, CA 93950-2579
(925) 519-0391
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
26928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26928
LICENSE
CA
Enumeration date
01/08/2015
Last updated
01/08/2015
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