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NPI Code Detail

MEDICARE: LISSETTE M FLORES

MEDICARE: LISSETTE M FLORES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorR1352410619CA
2225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1215599857
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISSETTE M FLORES
Provider Business Mailing Address
First Line : 5473 KEARNY VILLA RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1150
Country : US
Telephone Number : 858-394-4847
Fax Number : 619-684-7004
Provider Business Practice Location Address
First Line : 7545 METROPOLITAN DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4402
Country : US
Telephone Number : 619-718-9890
Fax Number : 619-718-9897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 01/08/2026

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Directions to “ LISSETTE M FLORES ” Practice Location

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