Provider Demographics
NPI:1023429669
Name:MOLZAHN, LORENA K (RPH)
Entity type:Individual
Prefix:DR
First Name:LORENA
Middle Name:K
Last Name:MOLZAHN
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 1:715 E BIDWELL ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3341
Mailing Address - Country:US
Mailing Address - Phone:916-983-6574
Mailing Address - Fax:916-983-2639
Practice Address - Street 1:715 E BIDWELL ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3341
Practice Address - Country:US
Practice Address - Phone:916-983-6574
Practice Address - Fax:916-983-2639
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist