Georgia Nicole Difiore, PHARM.D.
Individual provider Active NPI Pharmacist · Freedom, CA
NPI 1477959534 · NPPES record last updated Nov 17, 2014
Key facts
- NPI
- 1477959534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 71948 (CA)
- Practice address
- 1810 Freedom Blvd
Freedom, CA 95019-3000 - Phone
- (831) 768-0183
- NPI assigned
- Nov 17, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71948 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 71948 | CA | Yes |
Addresses
Primary practice location
1810 Freedom Blvd
Freedom, CA 95019-3000
Mailing address
1810 Freedom Blvd
Freedom, CA 95019-3000
Other providers in Freedom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2014. 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.