Provider Demographics
NPI:1487374716
Name:FLORES, ANDREA C (ATC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:C
Last Name:FLORES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11089 S MENDOCINO AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-9711
Mailing Address - Country:US
Mailing Address - Phone:553-213-3146
Mailing Address - Fax:
Practice Address - Street 1:2940 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-8474
Practice Address - Country:US
Practice Address - Phone:553-327-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer