Provider Demographics
NPI:1477185627
Name:FLOWERS, DAIRIE Y
Entity Type:Individual
Prefix:
First Name:DAIRIE
Middle Name:Y
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 CANYON VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-6103
Mailing Address - Country:US
Mailing Address - Phone:707-716-4858
Mailing Address - Fax:
Practice Address - Street 1:2218 CANYON VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-6103
Practice Address - Country:US
Practice Address - Phone:707-716-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician