Provider Demographics
NPI:1497032189
Name:MATHEWS, PATRICIA WHITNEY (RPH)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:WHITNEY
Last Name:MATHEWS
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 1:551 LAGUNA CANYON WAY
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3540
Mailing Address - Country:US
Mailing Address - Phone:714-990-6716
Mailing Address - Fax:
Practice Address - Street 1:200 W ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2900
Practice Address - Country:US
Practice Address - Phone:714-992-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist