Provider Demographics
NPI:1043881808
Name:SHAHZADI, ANEEBA
Entity Type:Individual
Prefix:
First Name:ANEEBA
Middle Name:
Last Name:SHAHZADI
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 1:2784 GARRETT PL
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-5330
Mailing Address - Country:US
Mailing Address - Phone:530-668-9047
Mailing Address - Fax:
Practice Address - Street 1:2784 GARRETT PL
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-5330
Practice Address - Country:US
Practice Address - Phone:530-668-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist