Provider Demographics
NPI:1326414897
Name:SENO, FERN-ANN (RPH)
Entity Type:Individual
Prefix:
First Name:FERN-ANN
Middle Name:
Last Name:SENO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7744 ALLENGROVE ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2613
Mailing Address - Country:US
Mailing Address - Phone:714-264-0095
Mailing Address - Fax:
Practice Address - Street 1:2615 TUSCANY ST
Practice Address - Street 2:TARGET STORE 2615 PHARMACY DEPT
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881
Practice Address - Country:US
Practice Address - Phone:951-277-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist