Provider Demographics
NPI:1033104872
Name:LEE, CHRISTINE VEVECKA (PHARMD, CLS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:VEVECKA
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD, CLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 VIA MADRID ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746
Mailing Address - Country:US
Mailing Address - Phone:916-773-7227
Mailing Address - Fax:
Practice Address - Street 1:6025 VIA MADRID
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-5802
Practice Address - Country:US
Practice Address - Phone:916-773-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist