Healthcare Provider Details

I. General information

NPI: 1316891070
Provider Name (Legal Business Name): KATERI FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12810 HEACOCK ST STE B202
MORENO VALLEY CA
92553-2873
US

IV. Provider business mailing address

1440 BEAUMONT AVE STE A2-303
BEAUMONT CA
92223-6820
US

V. Phone/Fax

Practice location:
  • Phone: 951-247-6542
  • Fax:
Mailing address:
  • Phone:
  • 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: