Provider Demographics
NPI:1780740753
Name:BARRERA, ORIETTA M (DENTAL HYGIENIST)
Entity type:Individual
Prefix:MRS
First Name:ORIETTA
Middle Name:M
Last Name:BARRERA
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40330 CAMINO CAMPOS VERDE
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6170
Mailing Address - Country:US
Mailing Address - Phone:951-541-1206
Mailing Address - Fax:951-587-6138
Practice Address - Street 1:40330 CAMINO CAMPOS VERDE
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6170
Practice Address - Country:US
Practice Address - Phone:951-541-1206
Practice Address - Fax:951-587-6138
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP39124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH00039-01OtherMEDI-CAL DENTAL PROGRAM