Active NPI
Petra Anne Fletcher
- Pharmacy Technician
- Lomita, CA
National Provider Identifier
1124617527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- TCH8046
- Practice address
- 2001 Pacific Coast Hwy
Lomita, CA 90717-2604 - Phone
- (310) 517-9535
- Fax
- (310) 517-9552
- NPI assigned
- Jan 12, 2021
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | TCH8046 | CA | Primary |
Addresses
Primary practice location
2001 Pacific Coast Hwy
Lomita, CA 90717-2604
Mailing address
128 E 232ND PL
Carson, CA 90745-5311
Phone (310) 809-7387
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | petraf@ca.rr.com |
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 |
|---|---|---|---|
| TCH8046 | CA | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1124617527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 E 232ND PL",
"city": "CARSON",
"state": "CA",
"postal_code": "907455311",
"telephone_number": "310-809-7387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 PACIFIC COAST HWY",
"city": "LOMITA",
"state": "CA",
"postal_code": "907172604",
"telephone_number": "310-517-9535",
"fax_number": "310-517-9552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "PETRA",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-12",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "CA",
"license": "TCH8046",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "petraf@ca.rr.com",
"affiliation": "N",
"address_1": "2001 Pacific Coast Hwy",
"city": "Lomita",
"state": "CA",
"country_code": "US",
"postal_code": "907172604",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lomita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.