Healthcare Provider Details

I. General information

NPI: 1548173891
Provider Name (Legal Business Name): ROSA EDRICH PHARMACY TECHNICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 MAYFIELD RD UNIT 141C
SEAL BEACH CA
90740-3658
US

IV. Provider business mailing address

1381 MAYFIELD RD UNIT 141C
SEAL BEACH CA
90740-3658
US

V. Phone/Fax

Practice location:
  • Phone: 310-701-8840
  • Fax:
Mailing address:
  • Phone: 714-980-3665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number51136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: