Healthcare Provider Details

I. General information

NPI: 1366388027
Provider Name (Legal Business Name): MARITSA GRIJALVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9311 OAK ST
BELLFLOWER CA
90706-4407
US

IV. Provider business mailing address

9311 OAK ST
BELLFLOWER CA
90706-4407
US

V. Phone/Fax

Practice location:
  • Phone: 562-916-6416
  • Fax:
Mailing address:
  • Phone: 562-916-6416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number205776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: