MEDICARE: KRISTA MISTRETTA PHARMD

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
1	183500000X	Pharmacist	84926	CA

General Provider Information

NPI Number	:	1407507890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA MISTRETTA PHARMD

Provider Business Mailing Address
First Line	:	5254 BAY ST
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95765-5510
Country	:	US
Telephone Number	:	916-622-0422
Fax Number	:

Provider Business Practice Location Address
First Line	:	5254 BAY ST
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95765-5510
Country	:	US
Telephone Number	:	916-622-0422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	01/17/2022

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Directions to “ KRISTA MISTRETTA PHARMD” Practice Location

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