Provider Demographics
NPI:1679607790
Name:APPS, FELESHIA L
Entity type:Individual
Prefix:DR
First Name:FELESHIA
Middle Name:L
Last Name:APPS
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 1:430 PUERTO PL
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-7300
Mailing Address - Country:US
Mailing Address - Phone:510-910-1041
Mailing Address - Fax:
Practice Address - Street 1:2600 S TRACY BLVD
Practice Address - Street 2:#160
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-9103
Practice Address - Country:US
Practice Address - Phone:510-910-1041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55054122300000X
CACA550541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist