Provider Demographics
NPI:1114479995
Name:WEEKES, SEAN (RPH)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:WEEKES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 CREEKSIDE DR
Mailing Address - Street 2:APT 3021
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5673
Mailing Address - Country:US
Mailing Address - Phone:925-322-7729
Mailing Address - Fax:
Practice Address - Street 1:801 IRVING STREET
Practice Address - Street 2:SUSNET WELLNESS PHARMACY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122
Practice Address - Country:US
Practice Address - Phone:415-664-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist