Provider Demographics
NPI:1841055332
Name:FLORES, LORETTA SOLEDAD (EDS)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:SOLEDAD
Last Name:FLORES
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30800 SAN LUIS REY DR
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-6045
Mailing Address - Country:US
Mailing Address - Phone:760-416-8823
Mailing Address - Fax:
Practice Address - Street 1:30800 SAN LUIS REY DR
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-6045
Practice Address - Country:US
Practice Address - Phone:760-416-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool