Provider Demographics
NPI:1518322619
Name:TRAT, STEPHANIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:TRAT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 S SANTA ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-4603
Mailing Address - Country:US
Mailing Address - Phone:626-372-5819
Mailing Address - Fax:
Practice Address - Street 1:1345 N MONTEBELLO BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-2585
Practice Address - Country:US
Practice Address - Phone:323-890-0069
Practice Address - Fax:323-890-9277
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist