Active NPI
Kathryn Erosa
- Pharmacist
- Jackson, CA
National Provider Identifier
1053844902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 41811
- Practice address
- 515 Highway 49 South
Jackson, CA 95642 - Phone
- (209) 223-2471
- NPI assigned
- Apr 7, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 41811 | CA | Primary |
Addresses
Primary practice location
515 Highway 49 South
Jackson, CA 95642
Mailing address
11356 Clinton Bar Rd
Pine Grove, CA 95665-9762
Phone (209) 765-8013
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41811 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past | Accepting new patients | |
| Longs Drug Stores California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503532800000",
"number": "1053844902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11356 CLINTON BAR RD",
"city": "PINE GROVE",
"state": "CA",
"postal_code": "956659762",
"telephone_number": "209-765-8013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 HIGHWAY 49 SOUTH",
"city": "JACKSON",
"state": "CA",
"postal_code": "95642",
"telephone_number": "209-223-2471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EROSA",
"first_name": "KATHRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-07",
"last_updated": "2017-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "41811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.