Individual
REENA POTILLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2751 DEL PASO RD, SACRAMENTO, CA 95835-2303
(916) 285-9372
Mailing address
2751 DEL PASO RD, SACRAMENTO, CA 95835-2303
(916) 285-9372
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
67924
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548276835
—
CA
Enumeration date
08/16/2021
Last updated
08/16/2021
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