Provider Demographics
NPI:1093327538
Name:PIANTEDOSI, LORELEI JEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LORELEI
Middle Name:JEAN
Last Name:PIANTEDOSI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-1336
Mailing Address - Country:US
Mailing Address - Phone:202-494-1051
Mailing Address - Fax:
Practice Address - Street 1:90 7TH ST STE 5-300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-6706
Practice Address - Country:US
Practice Address - Phone:415-744-3642
Practice Address - Fax:443-380-7351
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH52108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist