Provider Demographics
NPI:1457967796
Name:FLORES, ANNELA L (MT-BC)
Entity Type:Individual
Prefix:
First Name:ANNELA
Middle Name:L
Last Name:FLORES
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10455 SORRENTO VALLEY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1622
Mailing Address - Country:US
Mailing Address - Phone:858-475-2201
Mailing Address - Fax:
Practice Address - Street 1:10455 SORRENTO VALLEY RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1620
Practice Address - Country:US
Practice Address - Phone:858-475-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist