Provider Demographics
NPI:1992023162
Name:JEDNOROZEC, PATRICIA HOFFMAN (RDHAP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:HOFFMAN
Last Name:JEDNOROZEC
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 1:4120 ENCHANTED CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8411
Mailing Address - Country:US
Mailing Address - Phone:916-751-9256
Mailing Address - Fax:916-789-0443
Practice Address - Street 1:4120 ENCHANTED CIRCLE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8411
Practice Address - Country:US
Practice Address - Phone:916-751-9256
Practice Address - Fax:916-789-0443
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP # 129124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist