Provider Demographics
NPI:1467193425
Name:FLORES, YESENIA ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:ELIZABETH
Last Name:FLORES
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 1:563 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-5349
Mailing Address - Country:US
Mailing Address - Phone:909-372-8545
Mailing Address - Fax:
Practice Address - Street 1:563 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-5349
Practice Address - Country:US
Practice Address - Phone:909-372-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty