Provider Demographics
NPI:1477834844
Name:LA MATTINA-HAWKINS, COBY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COBY
Middle Name:ANN
Last Name:LA MATTINA-HAWKINS
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 1:10451 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-1987
Mailing Address - Country:US
Mailing Address - Phone:916-780-2898
Mailing Address - Fax:
Practice Address - Street 1:10451 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-1987
Practice Address - Country:US
Practice Address - Phone:916-780-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist