Active NPI
Thelma Porras-Guaderrama, R.D.H.
- Dental Hygienist
- Pittsburg, CA
National Provider Identifier
1952758823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 30121
- Practice address
- 339 E Leland Rd
Pittsburg, CA 94565-4911 - Phone
- (925) 628-5399
- NPI assigned
- May 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 30121 | CA | Primary |
Addresses
Primary practice location
339 E Leland Rd
Pittsburg, CA 94565-4911
Mailing address
5065 Tehachapi Way
Antioch, CA 94531-8808
Phone (925) 431-1250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30121 | CA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de la Raza Inc | Past | Accepting new patients | |
| La Clinica de la Raza Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1346262292
-
- Federally Qualified Health Center (FQHC)
- Pittsburg, CA
- NPI 1528080470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1952758823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5065 TEHACHAPI WAY",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318808",
"telephone_number": "925-431-1250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 E LELAND RD",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945654911",
"telephone_number": "925-628-5399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORRAS-GUADERRAMA",
"first_name": "THELMA",
"credential": "R.D.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-19",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "30121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.