Granados Johnson, Myrna Lillia
Granados Johnson, Myrna Lillia is an individual health care provider with primary practice located at 19270 Sonoma Highway 12 , Sonoma CA 95476-5414. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Granados Johnson, Myrna Lillia can be contacted via phone (707) 939-6070.Contact Information
Primary practice address
19270 Sonoma Highway 12
Sonoma CA 95476-5414
Phone: (707) 939-6070
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | HAP 599 | California |
Profile Details
| NPI number | 1548702533 |
|---|---|
| LBN Legal business name | Granados Johnson, Myrna Lillia |
| Credentials | RDH AP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2016 |
| Last updated | Nov 8th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548702533 | NPPES |
| California | Other | 1770669715 | MEDI-CAL FQHC |
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