Healthcare Provider Details

I. General information

NPI: 1114247038
Provider Name (Legal Business Name): CHARLENE FLORINA LAUREL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHARLENE DAVID FLORINA RPH

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 QUALITY DR
VACAVILLE CA
95688-9494
US

IV. Provider business mailing address

1 QUALITY DR
VACAVILLE CA
95688-9494
US

V. Phone/Fax

Practice location:
  • Phone: 707-624-3152
  • Fax: 707-624-3057
Mailing address:
  • Phone: 707-624-3152
  • Fax: 707-624-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 66979
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60241441
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: