Provider Demographics
NPI:1619033255
Name:HAGEY, DEBORAH AILEEN (RDHAP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:AILEEN
Last Name:HAGEY
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:AILEEN
Other - Last Name:DURBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDHAP
Mailing Address - Street 1:2525 VICTOR AVE.
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1465
Mailing Address - Country:US
Mailing Address - Phone:530-222-2284
Mailing Address - Fax:530-222-2648
Practice Address - Street 1:2525 VICTOR AVE,
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1465
Practice Address - Country:US
Practice Address - Phone:530-222-2284
Practice Address - Fax:530-222-2648
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP68124Q00000X
CARDH15429124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist