Jason Camiling, RDH

Individual provider Active NPI Dental Hygienist · Vallejo, CA

NPI 1992278147 · NPPES record last updated Jan 9, 2019

Key facts

NPI
1992278147
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
21860 (CA)
Practice address
133 Plaza Dr
Vallejo, CA 94591-3703
Phone
(707) 557-6245
NPI assigned
Jan 9, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
21860CAMDClinical Child & Adolescent Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 21860 CA Yes

Addresses

Primary practice location

133 Plaza Dr
Vallejo, CA 94591-3703

Mailing address

133 Plaza Dr
Vallejo, CA 94591-3703

Other identifiers

IdentifierTypeStateIssuer
21860OtherCARDH
21860MedicaidCA

Other providers in Vallejo, CA

All providers in Vallejo, CA · Dental Hygienist in California

Sources for this page

Verify at the official NPI Registry.