Provider Demographics
NPI:1346784246
Name:XAVIOER, SHARON PULIKKOTTIL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:PULIKKOTTIL
Last Name:XAVIOER
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 1:2720 S BRISTOL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6207
Mailing Address - Country:US
Mailing Address - Phone:714-426-5468
Mailing Address - Fax:714-426-5215
Practice Address - Street 1:2720 S BRISTOL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6207
Practice Address - Country:US
Practice Address - Phone:714-426-5468
Practice Address - Fax:714-426-5215
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76015183500000X, 1835P0018X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care