Provider Demographics
NPI:1235295205
Name:RAYA, ROSALINDA L (DDS)
Entity Type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:L
Last Name:RAYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 POLLASKY
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLOUIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612
Mailing Address - Country:US
Mailing Address - Phone:559-298-2231
Mailing Address - Fax:559-298-3148
Practice Address - Street 1:106 POLLASKY
Practice Address - Street 2:SUITE B
Practice Address - City:CLOUIS
Practice Address - State:CA
Practice Address - Zip Code:93612
Practice Address - Country:US
Practice Address - Phone:559-298-2231
Practice Address - Fax:559-298-3148
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA254421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice