Provider Demographics
NPI:1114399250
Name:SANFORD, JANELL (PHARM D)
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:
Last Name:SANFORD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 BAY LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5339
Mailing Address - Country:US
Mailing Address - Phone:650-324-1514
Mailing Address - Fax:
Practice Address - Street 1:871 SANTA CRUZ AVE
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4629
Practice Address - Country:US
Practice Address - Phone:650-618-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 50275183500000X
NV14708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist