Individual provider Active NPI

Kathy Audrey Terra, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Grass Valley, CA
National Provider Identifier
1104564632
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
136265 Issued in CA
Practice address
280 Sierra College Dr Ste 210
Grass Valley, CA 95945-5769
Phone
(530) 273-8452
NPI assigned
May 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 136265 CA Primary

Addresses

Primary practice location

280 Sierra College Dr Ste 210
Grass Valley, CA 95945-5769

Mailing address

10859 Walker Dr
Grass Valley, CA 95945-6912
Phone (530) 216-9163

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

LicenseStateTypeSpecialty
136265CAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1104564632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10859 WALKER DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959456912",
            "telephone_number": "530-216-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DR STE 210",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455769",
            "telephone_number": "530-273-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRA",
        "first_name": "KATHY",
        "middle_name": "AUDREY",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "136265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.

Verify at the official NPI Registry.