Provider Demographics
NPI:1235439993
Name:MCQUEEN, SABRINA MARIE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:MARIE
Last Name:MCQUEEN
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:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-0785
Mailing Address - Country:US
Mailing Address - Phone:415-269-3707
Mailing Address - Fax:510-658-2552
Practice Address - Street 1:5130 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4620
Practice Address - Country:US
Practice Address - Phone:510-658-5693
Practice Address - Fax:510-658-2552
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist