Provider Demographics
NPI:1164722161
Name:PELEN, BROOKE EILEEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:EILEEN
Last Name:PELEN
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:SHS BLDG 588
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-0001
Mailing Address - Country:US
Mailing Address - Phone:805-893-2116
Mailing Address - Fax:805-893-2736
Practice Address - Street 1:SHS BLDG 588
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-2715
Practice Address - Country:US
Practice Address - Phone:805-969-4728
Practice Address - Fax:805-969-2069
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH55218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist