Active NPI
Irene Relatado, PHARMACIST
- Pharmacist
- Fullerton, CA
National Provider Identifier
1104353135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54451
- Practice address
- 455 N State College Blvd
Fullerton, CA 92831-4258 - Phone
- (714) 871-6700
- NPI assigned
- May 22, 2017
- 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 | 54451 | CA | Primary |
Addresses
Primary practice location
455 N State College Blvd
Fullerton, CA 92831-4258
Mailing address
455 N State College Blvd
Fullerton, CA 92831-4258
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 |
|---|---|---|---|
| 54451 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | 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.
-
- Pharmacy
- Fullerton, CA
- NPI 1831134725
-
- Pharmacy
- Jurupa Valley, CA
- NPI 1780573113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515715200000",
"number": "1104353135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 N STATE COLLEGE BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928314258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 N STATE COLLEGE BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928314258",
"telephone_number": "714-871-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RELATADO",
"first_name": "IRENE",
"name_prefix": "Ms.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-22",
"last_updated": "2018-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "54451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.