Provider Demographics
NPI:1881881803
Name:FLORES, DESIRAE (ADC)
Entity type:Individual
Prefix:
First Name:DESIRAE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24384 SUNNYMEAD BLVD.
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553
Mailing Address - Country:US
Mailing Address - Phone:951-243-0303
Mailing Address - Fax:951-243-3006
Practice Address - Street 1:24384 SUNNYMEAD BLVD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3069
Practice Address - Country:US
Practice Address - Phone:951-243-0303
Practice Address - Fax:951-243-3006
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)