Provider Demographics
NPI:1578150710
Name:CANTU, KATHERINE ERIKA (PHARMACIST D)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ERIKA
Last Name:CANTU
Suffix:
Gender:F
Credentials:PHARMACIST D
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ERIKA
Other - Last Name:GOERTZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19539 E SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-9634
Mailing Address - Country:US
Mailing Address - Phone:550-305-5376
Mailing Address - Fax:
Practice Address - Street 1:445 11TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE COVE
Practice Address - State:CA
Practice Address - Zip Code:93646-2211
Practice Address - Country:US
Practice Address - Phone:559-626-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist