Provider Demographics
NPI:1598055451
Name:CARAMANCION, STEPHANIE PAJIMNA
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:PAJIMNA
Last Name:CARAMANCION
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 1:5212 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-3475
Mailing Address - Country:US
Mailing Address - Phone:559-733-5404
Mailing Address - Fax:559-733-4028
Practice Address - Street 1:5212 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-3475
Practice Address - Country:US
Practice Address - Phone:559-733-5404
Practice Address - Fax:559-733-4028
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist