Active NPI
Cassandra Formales, PHARMD
- Pharmacist
- San Diego, CA
National Provider Identifier
1952896367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73032
- Practice address
- 11403 Matinal Cir
San Diego, CA 92127-1235 - Phone
- (714) 600-7101
- NPI assigned
- Jun 27, 2018
- 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 | 73032 | CA | Primary |
Addresses
Primary practice location
11403 Matinal Cir
San Diego, CA 92127-1235
Mailing address
11403 Matinal Cir
San Diego, CA 92127-1235
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73032 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530057600000",
"number": "1952896367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11403 MATINAL CIR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921271235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11403 MATINAL CIR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921271235",
"telephone_number": "714-600-7101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMALES",
"first_name": "CASSANDRA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-27",
"last_updated": "2018-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.