Provider Demographics
NPI:1801222351
Name:ALCARAZ CANO, ARACELI (RDA)
Entity Type:Individual
Prefix:MRS
First Name:ARACELI
Middle Name:
Last Name:ALCARAZ CANO
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:ARACELI
Other - Middle Name:
Other - Last Name:ALCARAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3980 DALTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062-1214
Mailing Address - Country:US
Mailing Address - Phone:323-590-8013
Mailing Address - Fax:
Practice Address - Street 1:3980 DALTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-1214
Practice Address - Country:US
Practice Address - Phone:323-590-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDA 78437126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant