Provider Demographics
NPI:1356625644
Name:FELIX, MARIE HELENE MORATO (RPH)
Entity type:Individual
Prefix:
First Name:MARIE HELENE
Middle Name:MORATO
Last Name:FELIX
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 1:17791 SWEETGUM LN
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3825
Mailing Address - Country:US
Mailing Address - Phone:661-424-0366
Mailing Address - Fax:
Practice Address - Street 1:5001 WEST AVE N
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536
Practice Address - Country:US
Practice Address - Phone:661-722-5892
Practice Address - Fax:661-943-8062
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist