Provider Demographics
NPI:1487745469
Name:VALDERRAMA, CLARINDA T (DDS)
Entity type:Individual
Prefix:
First Name:CLARINDA
Middle Name:T
Last Name:VALDERRAMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 GELLERT BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015
Mailing Address - Country:US
Mailing Address - Phone:650-757-1749
Mailing Address - Fax:650-758-1592
Practice Address - Street 1:343 GELLERT BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-757-1749
Practice Address - Fax:650-758-1592
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist