Provider Demographics
NPI:1508189358
Name:KORNBLUEH PEREZ, CATALINA (RDHAP, RDH)
Entity Type:Individual
Prefix:MS
First Name:CATALINA
Middle Name:
Last Name:KORNBLUEH PEREZ
Suffix:
Gender:F
Credentials:RDHAP, RDH
Other - Prefix:MS
Other - First Name:CATALINA
Other - Middle Name:
Other - Last Name:BLANCO PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDHAP, RDH
Mailing Address - Street 1:100 S MURPHY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6118
Mailing Address - Country:US
Mailing Address - Phone:650-861-1965
Mailing Address - Fax:650-434-0418
Practice Address - Street 1:100 S MURPHY AVE STE 200
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6118
Practice Address - Country:US
Practice Address - Phone:650-861-1965
Practice Address - Fax:650-434-0418
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP 264124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist