Mariah Foley
Individual provider Active NPI Pharmacist · Lakeside, CA
NPI 1073260428 · NPPES record last updated Mar 6, 2022
Key facts
- NPI
- 1073260428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 85966 (CA)
- Practice address
- 13344 Lakeshore Dr
Lakeside, CA 92040-3406 - Phone
- (619) 201-2888
- NPI assigned
- Mar 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 85966 | CA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 85966 | CA | Yes |
Addresses
Primary practice location
13344 Lakeshore Dr
Lakeside, CA 92040-3406
Mailing address
13344 Lakeshore Dr
Lakeside, CA 92040-3406
Other providers in Lakeside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2022. 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.