Provider Demographics
NPI:1578926127
Name:DESROSIERS, RHIANN
Entity Type:Individual
Prefix:
First Name:RHIANN
Middle Name:
Last Name:DESROSIERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 CASTRO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2019
Mailing Address - Country:US
Mailing Address - Phone:415-864-7030
Mailing Address - Fax:415-864-7071
Practice Address - Street 1:445 CASTRO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2019
Practice Address - Country:US
Practice Address - Phone:415-864-7030
Practice Address - Fax:415-864-7071
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist