Provider Demographics
NPI:1457504979
Name:SOUKIASIAN, NOUNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NOUNE
Middle Name:
Last Name:SOUKIASIAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-1951
Mailing Address - Country:US
Mailing Address - Phone:916-955-4823
Mailing Address - Fax:916-483-6667
Practice Address - Street 1:4701 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2953
Practice Address - Country:US
Practice Address - Phone:916-483-8479
Practice Address - Fax:916-483-6667
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist