Individual provider · NPI-1
Karina Ballesteros, RDHAP
Advanced Practice Dental Therapist · Livermore, CA
NPI number1376243758
StatusActive
Last updated in NPPESMar 19, 2023
Details
- NPI
- 1376243758
- Entity type
- Individual (NPI-1)
- Name
- Karina Ballesteros
- Credential
- RDHAP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 6, 2023
- Certification date
- Mar 19, 2023
- Last updated
- Mar 19, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 125K00000X | Advanced Practice Dental Therapist | 944 | CA | Yes |
Practice location
1498 N Vasco RdLivermore, CA 94551-9213
Phone 925-454-1132
Mailing address
101 E Vineyard AveSte 119 #112
Livermore, CA 94550
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