Individual
DAWN RAE KIRSTEN DE LA VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
21823 BLUE HORIZON CT, BIG OAK VALLEY, CA 95977-9518
(530) 798-3115
Mailing address
PO BOX 557, PENN VALLEY, CA 95946-0557
(530) 798-3115
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP1052
CA
133N00000X
Nutritionist
HAP1052
CA
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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