Provider Demographics
NPI:1407414261
Name:LANE-WILLIAMS, ROSALIND MICHELLE (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:MICHELLE
Last Name:LANE-WILLIAMS
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 W LAS POSITAS BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4939
Mailing Address - Country:US
Mailing Address - Phone:925-462-3530
Mailing Address - Fax:925-462-2678
Practice Address - Street 1:6155 W LAS POSITAS BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4939
Practice Address - Country:US
Practice Address - Phone:925-462-3530
Practice Address - Fax:925-462-2678
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16325183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATCH16325OtherPHARMACY TECHNICIAN