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NPI Code Detail

MEDICARE: MARIA LIZA RICAFORT

MEDICARE:   MARIA LIZA  RICAFORT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist56775CA

General Provider Information

NPI Number : 1659654614
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA LIZA RICAFORT
Provider Business Mailing Address
First Line : 1609 SNOW GOOSE WAY
Second Line :
City : ROSEVILLE
State : CA
Zip : 95747-4900
Country : US
Telephone Number : 530-591-9110
Fax Number :
Provider Business Practice Location Address
First Line : 6819 WATT AVE
Second Line :
City : NORTH HIGHLANDS
State : CA
Zip : 95660-3203
Country : US
Telephone Number : 916-339-0189
Fax Number : 916-339-0195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2011
Last Update Date : 09/26/2011

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Directions to “ MARIA LIZA RICAFORT ” Practice Location

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