Provider Demographics
NPI:1326323858
Name:NG, CONSTANCE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:NG
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 1:2201 VERNE ROBERTS CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-7911
Mailing Address - Country:US
Mailing Address - Phone:925-757-1933
Mailing Address - Fax:925-757-2291
Practice Address - Street 1:2201 VERNE ROBERTS CIR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-7911
Practice Address - Country:US
Practice Address - Phone:925-757-1933
Practice Address - Fax:925-757-2291
Is Sole Proprietor?:No
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist