Provider Demographics
NPI:1962876482
Name:DEVENS, CLAUDIA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:DEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 WEST 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:DORRIS
Mailing Address - State:CA
Mailing Address - Zip Code:96023
Mailing Address - Country:US
Mailing Address - Phone:530-397-8411
Mailing Address - Fax:
Practice Address - Street 1:610 WEST 3RD STREET
Practice Address - Street 2:
Practice Address - City:DORRIS
Practice Address - State:CA
Practice Address - Zip Code:96023
Practice Address - Country:US
Practice Address - Phone:530-397-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH 6004124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARDH 6004OtherLICENSE NUMBER