Provider Demographics
NPI:1295973386
Name:OWENS, PATRICIA (DENTAL HYGIENIST HAP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST HAP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DENTAL HYGIENIST AP
Mailing Address - Street 1:3721 CLUBSIDE LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2008
Mailing Address - Country:US
Mailing Address - Phone:916-419-4508
Mailing Address - Fax:
Practice Address - Street 1:3721 CLUBSIDE LANE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-2005
Practice Address - Country:US
Practice Address - Phone:916-419-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA228124Q00000X
CA5639124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist