Provider Demographics
NPI:1366698599
Name:MARSHALL, DEBBIE JACQUELINE (RDHAP)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:JACQUELINE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PISANO ST
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1531
Mailing Address - Country:US
Mailing Address - Phone:949-525-7285
Mailing Address - Fax:
Practice Address - Street 1:23 PISANO ST
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-1531
Practice Address - Country:US
Practice Address - Phone:949-525-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17050124Q00000X
CAHAP275124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist