Provider Demographics
NPI:1932699048
Name:RANGEL, ROSALINA A
Entity Type:Individual
Prefix:
First Name:ROSALINA
Middle Name:A
Last Name:RANGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 LA SIERRA AVE # 1018
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5271
Mailing Address - Country:US
Mailing Address - Phone:951-354-9999
Mailing Address - Fax:951-354-6666
Practice Address - Street 1:3380 LA SIERRA AVE # 1018
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5271
Practice Address - Country:US
Practice Address - Phone:951-354-9999
Practice Address - Fax:951-354-6666
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69543126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant