Healthcare Provider Details

I. General information

NPI: 1679871636
Provider Name (Legal Business Name): KASEY LE FLORES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KASEY LE

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUREKA RD
ROSEVILLE CA
95661-3027
US

IV. Provider business mailing address

1600 EUREKA RD
ROSEVILLE CA
95661-3027
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-4050
  • Fax:
Mailing address:
  • Phone: 916-784-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number61231
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: