Provider Demographics
NPI:1528468865
Name:ABULENCIA, RAQUEL GUEVARRA (RPH)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:GUEVARRA
Last Name:ABULENCIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:GUEVARRA
Other - Last Name:ABULENCIA-MCFIREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:14061 W WHITESBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-9297
Mailing Address - Country:US
Mailing Address - Phone:559-846-1203
Mailing Address - Fax:
Practice Address - Street 1:14061 W WHITESBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-9297
Practice Address - Country:US
Practice Address - Phone:559-846-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60781183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA60781OtherPHARMACIST STATE LICENSE NUMBER