Provider Demographics
NPI:1760152656
Name:ECHEAGARAY, JEWELENA RENE (RDA)
Entity type:Individual
Prefix:MRS
First Name:JEWELENA
Middle Name:RENE
Last Name:ECHEAGARAY
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 RUSH RIVER DR APT 43
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-4939
Mailing Address - Country:US
Mailing Address - Phone:559-210-2260
Mailing Address - Fax:
Practice Address - Street 1:1108 CORPORATE WAY STE 1
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-6119
Practice Address - Country:US
Practice Address - Phone:916-424-1703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH37145124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist