Provider Demographics
NPI:1376663211
Name:FRAUSTO, SONA B (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:SONA
Middle Name:B
Last Name:FRAUSTO
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:B
Other - Last Name:FRAUSTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH, PHARMD
Mailing Address - Street 1:414 15TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-1622
Mailing Address - Country:US
Mailing Address - Phone:916-452-1334
Mailing Address - Fax:916-452-8209
Practice Address - Street 1:1125 ALHAMBRA BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5286
Practice Address - Country:US
Practice Address - Phone:916-452-1334
Practice Address - Fax:916-452-8209
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist