Provider Demographics
NPI:1083914154
Name:BRAY, STEPHANIE J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:J
Last Name:BRAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-2842
Mailing Address - Country:US
Mailing Address - Phone:925-356-2712
Mailing Address - Fax:925-356-2722
Practice Address - Street 1:4309 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2842
Practice Address - Country:US
Practice Address - Phone:925-356-2712
Practice Address - Fax:925-356-2722
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist