Provider Demographics
NPI:1356850952
Name:MARIANO, KATRINNE ANNE DIAZ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATRINNE ANNE
Middle Name:DIAZ
Last Name:MARIANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9305 MISSION GORGE RD
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3815
Mailing Address - Country:US
Mailing Address - Phone:619-258-8011
Mailing Address - Fax:209-341-0849
Practice Address - Street 1:9305 MISSION GORGE RD
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3815
Practice Address - Country:US
Practice Address - Phone:619-258-8011
Practice Address - Fax:209-341-0849
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062186183500000X
CA75668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist