Healthcare Provider Details

I. General information

NPI: 1609450774
Provider Name (Legal Business Name): KATHERINE ANGELA NORIEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 S MAIN ST
SANTA ANA CA
92707-3253
US

IV. Provider business mailing address

3101 S FAIRVIEW ST SPC 51
SANTA ANA CA
92704-6514
US

V. Phone/Fax

Practice location:
  • Phone: 714-327-1884
  • Fax: 714-327-1886
Mailing address:
  • Phone: 714-292-0345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: