Provider Demographics
NPI:1275794760
Name:DELFINO, ANGELA (RDHAP)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:
Last Name:DELFINO
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 1:6583 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-9349
Mailing Address - Country:US
Mailing Address - Phone:530-622-8741
Mailing Address - Fax:
Practice Address - Street 1:6583 RICHARD AVE
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-9349
Practice Address - Country:US
Practice Address - Phone:530-622-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA218124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist