Individual provider · NPI-1

Amy Victorino, RDA

Dental Assistant · Oakland, CA

NPI number1295093557
StatusActive
Last updated in NPPESApr 24, 2012

Details

NPI
1295093557
Entity type
Individual (NPI-1)
Name
Amy Victorino
Credential
RDA
Sex
Female
Sole proprietor
No
Enumeration date
Apr 24, 2012
Last updated
Apr 24, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
126800000X Dental Assistant76976CAYes

Practice location

2950 International Blvd
Oakland, CA 94601-2228

Phone 510-535-4450 · Fax 510-535-4494

Mailing address

2950 International Blvd
Oakland, CA 94601-2228

Phone 510-535-4450 · Fax 510-535-4494

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