Provider Demographics
NPI:1629554530
Name:ADAMS, EVA MARIA (RDHAP)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:MARIA
Last Name:ADAMS
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 1:4706 ASTER AVE
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-9435
Mailing Address - Country:US
Mailing Address - Phone:707-499-7059
Mailing Address - Fax:
Practice Address - Street 1:695 #3 RANCHERIA ROAD
Practice Address - Street 2:
Practice Address - City:BLUE LAKE
Practice Address - State:CA
Practice Address - Zip Code:95525
Practice Address - Country:US
Practice Address - Phone:707-266-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP694124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist