Etienne Jean De Dieu Matanda Matanda

Pharmacist · Kerman, CA

Individual Active NPI

NPI number 1811558703

Practice location

14967 W Whitesbridge Ave
Kerman, CA 93630-1111
Phone
(559) 842-0030

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NPI record

NPI
1811558703
Entity type
Individual (Type 1)
Enumeration date
June 22, 2019
Last updated
June 22, 2019
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X 79185 CA

Mailing address

285 S Kona Ave
Fresno, CA 93727-3481
Phone
(254) 366-1507

About Etienne Matanda Matanda

Etienne Jean De Dieu Matanda Matanda is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 14967 W Whitesbridge Ave, Kerman, CA 93630-1111. The NPI number 1811558703 was assigned on June 22, 2019 and the record was last updated on June 22, 2019.

Etienne Matanda Matanda lists a license in the registry: #79185 (CA) for Pharmacist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Etienne Jean De Dieu Matanda Matanda?

The NPI number is 1811558703.

What is the phone number of Etienne Matanda Matanda?

The phone number listed for the practice location is (559) 842-0030.

Where is Etienne Matanda Matanda located?

14967 W Whitesbridge Ave, Kerman, CA 93630-1111.

What is the taxonomy code for Etienne Matanda Matanda?

The primary taxonomy code is 183500000X – Pharmacist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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