Provider Demographics
NPI:1568982411
Name:PIERRE, STEPHANIE CHRISTELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CHRISTELLE
Last Name:PIERRE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:CHRISTELLE
Other - Last Name:DIOTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3263 CAMINITO EASTBLUFF UNIT 199
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-2840
Mailing Address - Country:US
Mailing Address - Phone:858-888-5462
Mailing Address - Fax:
Practice Address - Street 1:610 GATEWAY CENTER WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-4533
Practice Address - Country:US
Practice Address - Phone:619-262-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist