Provider Demographics
NPI:1467414813
Name:SPRAGUE-ABBOTT, ROBIN (PHARMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:SPRAGUE-ABBOTT
Suffix:
Gender:F
Credentials:PHARMD, MS
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:SPRAGUE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, MS
Mailing Address - Street 1:4410 WINDING RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-6516
Mailing Address - Country:US
Mailing Address - Phone:209-478-1125
Mailing Address - Fax:
Practice Address - Street 1:4725 QUAIL LAKES DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5243
Practice Address - Country:US
Practice Address - Phone:209-952-3599
Practice Address - Fax:209-952-3636
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist