Healthcare Provider Details

I. General information

NPI: 1275343170
Provider Name (Legal Business Name): LITZY AMERICA FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 13TH ST STE 108
MODESTO CA
95354-2437
US

IV. Provider business mailing address

1488 ORGULLO LN
MANTECA CA
95337-8760
US

V. Phone/Fax

Practice location:
  • Phone: 209-884-2424
  • Fax:
Mailing address:
  • Phone: 209-399-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: