Individual provider · NPI-1

Lisette Olivia Alonzo, RDA

Dental Assistant · Los Angeles, CA

NPI number1275914863
StatusActive
Last updated in NPPESJun 9, 2015

Details

NPI
1275914863
Entity type
Individual (NPI-1)
Name
Lisette Olivia Alonzo
Credential
RDA
Sex
Female
Sole proprietor
No
Enumeration date
Jun 9, 2015
Last updated
Jun 9, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
126800000X Dental Assistant689557CAYes

Practice location

2604 S Vermont Ave
Los Angeles, CA 90007-2298

Phone 323-731-3333

Mailing address

7969 Cleta St
Downey, CA 90241-4793

Phone 562-861-2746

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dental Assistant providers in Los Angeles, CA