Provider Demographics
NPI:1467517698
Name:DAVIS, TRINA RANI (RDHAP)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:RANI
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:RANI
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDHAP
Mailing Address - Street 1:533 W MELINDA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-1531
Mailing Address - Country:US
Mailing Address - Phone:559-623-1870
Mailing Address - Fax:
Practice Address - Street 1:533 W MELINDA AVE
Practice Address - Street 2:MOBILE DENYAL HYGIENE PRACTICE
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-6670
Practice Address - Country:US
Practice Address - Phone:559-623-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP26124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH00026-01OtherDENTI-CAL