Healthcare Provider Details

I. General information

NPI: 1528922671
Provider Name (Legal Business Name): LOURDES MARIE FLORES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1624 FRANKLIN ST STE 510
OAKLAND CA
94612-2823
US

IV. Provider business mailing address

610 17TH ST
MODESTO CA
95354-1205
US

V. Phone/Fax

Practice location:
  • Phone: 510-817-4515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: