Provider Demographics
NPI:1811716848
Name:FERRERAS, RICHELL JIMENEZ (RDH)
Entity type:Individual
Prefix:
First Name:RICHELL
Middle Name:JIMENEZ
Last Name:FERRERAS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15706 POMERADO RD STE 205
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2033
Mailing Address - Country:US
Mailing Address - Phone:858-674-5954
Mailing Address - Fax:
Practice Address - Street 1:15706 POMERADO RD STE 205
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2033
Practice Address - Country:US
Practice Address - Phone:858-674-5954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist