Provider Demographics
NPI:1952620148
Name:BOTHA, HESTER MARIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HESTER
Middle Name:MARIA
Last Name:BOTHA
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:PO BOX 90
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93581-0090
Mailing Address - Country:US
Mailing Address - Phone:661-822-9232
Mailing Address - Fax:661-822-1838
Practice Address - Street 1:811 TUCKER RD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2510
Practice Address - Country:US
Practice Address - Phone:661-822-9232
Practice Address - Fax:661-822-1838
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist