Healthcare Provider Details

I. General information

NPI: 1902196942
Provider Name (Legal Business Name): KATHERINE ANN RAYMOND PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE RAYMOND PHARM D

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49060 ROAD 426
OAKHURST CA
93644-8546
US

IV. Provider business mailing address

49060 ROAD 426
OAKHURST CA
93644-8546
US

V. Phone/Fax

Practice location:
  • Phone: 559-683-8882
  • Fax: 559-683-8854
Mailing address:
  • Phone: 559-683-8882
  • Fax: 559-683-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048766
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13669
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: