Heather Enos
Individual provider Active NPI Pharmacist · Patterson, CA
NPI 1720516701 · NPPES record last updated Jun 2, 2017
Key facts
- NPI
- 1720516701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 48764 (CA)
- Practice address
- 1080 Sperry Ave
Patterson, CA 95363-9267 - Phone
- (209) 892-6182
- NPI assigned
- Jun 2, 2017
- 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 |
|---|---|---|---|
| 48764 | CA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 48764 | CA | Yes |
Addresses
Primary practice location
1080 Sperry Ave
Patterson, CA 95363-9267
Mailing address
1080 Sperry Ave
Patterson, CA 95363-9267
Other providers in Patterson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2017. 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.