1205453503 NPI number — MRS. MARIA DE LOS ANGELES FLORES AOD COUNSELOR

Table of content: MRS. MARIA DE LOS ANGELES FLORES AOD COUNSELOR (NPI 1205453503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205453503 NPI number — MRS. MARIA DE LOS ANGELES FLORES AOD COUNSELOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLORES
Provider First Name:
MARIA
Provider Middle Name:
DE LOS ANGELES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AOD COUNSELOR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARRA
Provider Other First Name:
MARIA
Provider Other Middle Name:
DE LOS ANGELES
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1205453503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1496 N BEALE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARYSVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95901-6205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-749-8640
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1496 N BEALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARYSVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95901-6205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-749-8640
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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