Healthcare Provider Details

I. General information

NPI: 1649424243
Provider Name (Legal Business Name): CHERYL ANN STRIPLIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 NORMAN DR SUITE 103
MANTECA CA
95336-5925
US

IV. Provider business mailing address

1144 NORMAN DR SUITE 103
MANTECA CA
95336-5925
US

V. Phone/Fax

Practice location:
  • Phone: 209-923-4418
  • Fax: 209-923-4273
Mailing address:
  • Phone: 209-923-4418
  • Fax: 209-923-4273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY49005
License Number StateCA

VIII. Authorized Official

Name: CHERYL STRIPLIN
Title or Position: OWNER, PIC
Credential: RPH
Phone: 209-923-4418