Provider Demographics
NPI:1558930404
Name:SPOUNIAS, DEANNA LOUISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:LOUISE
Last Name:SPOUNIAS
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:PO BOX 8817
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92038-8817
Mailing Address - Country:US
Mailing Address - Phone:858-232-7414
Mailing Address - Fax:
Practice Address - Street 1:7018 BLAIR RD
Practice Address - Street 2:
Practice Address - City:CALIPATRIA
Practice Address - State:CA
Practice Address - Zip Code:92233-9633
Practice Address - Country:US
Practice Address - Phone:760-348-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03329155183500000X
CA63010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist