Active NPI
Cyd Charisse Dionaldo Fuentes, RPH
- Pharmacist
- Elk Grove, CA
National Provider Identifier
1013668334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH85517
- Practice address
- 5100 Laguna Blvd
Elk Grove, CA 95758-4159 - Phone
- (916) 684-7000
- NPI assigned
- Jan 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH85517 | CA | Primary |
Addresses
Primary practice location
5100 Laguna Blvd
Elk Grove, CA 95758-4159
Mailing address
8668 Scarlet Sage Way
Elk Grove, CA 95624-3853
Phone (916) 996-3273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH85517 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1013668334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8668 SCARLET SAGE WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956243853",
"telephone_number": "916-996-3273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 LAGUNA BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957584159",
"telephone_number": "916-684-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "CYD CHARISSE",
"middle_name": "DIONALDO",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-18",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH85517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.