Kristina Brenner
Individual provider Active NPI Pharmacist · Ceres, CA
NPI 1013363217 · NPPES record last updated May 6, 2016
Key facts
- NPI
- 1013363217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 66013 (CA)
- Practice address
- 2309 Dale Ave
Ceres, CA 95307-2708 - Phone
- (209) 725-5030
- NPI assigned
- May 6, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66013 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 66013 | CA | Yes |
Addresses
Primary practice location
2309 Dale Ave
Ceres, CA 95307-2708
Mailing address
2309 Dale Ave
Ceres, CA 95307-2708
Other providers in Ceres, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.