Provider Demographics
NPI:1285133520
Name:KEPICH, BARBARA LYNN
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LYNN
Last Name:KEPICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22015 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-7006
Mailing Address - Country:US
Mailing Address - Phone:310-750-1189
Mailing Address - Fax:310-750-0181
Practice Address - Street 1:22015 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-7006
Practice Address - Country:US
Practice Address - Phone:310-750-1189
Practice Address - Fax:310-750-0181
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist