Provider Demographics
NPI:1790543031
Name:HERNANDEZ-ARECHIGA, JUDITH NICOLLE (RDHAP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:NICOLLE
Last Name:HERNANDEZ-ARECHIGA
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 1:17935 E NEWBURGH ST
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-5722
Mailing Address - Country:US
Mailing Address - Phone:626-224-4563
Mailing Address - Fax:
Practice Address - Street 1:17935 E NEWBURGH ST
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-5722
Practice Address - Country:US
Practice Address - Phone:626-224-4563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1042124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist