Provider Demographics
NPI:1245776053
Name:MISNER, TRISHA (RDHAP)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:MISNER
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17958 PESANTE RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-1509
Mailing Address - Country:US
Mailing Address - Phone:831-206-2960
Mailing Address - Fax:
Practice Address - Street 1:17958 PESANTE RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-1509
Practice Address - Country:US
Practice Address - Phone:831-206-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA611124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist