Provider Demographics
NPI:1609413079
Name:BATISHEV, JULIANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:BATISHEV
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 1:4309 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-2842
Mailing Address - Country:US
Mailing Address - Phone:925-356-2712
Mailing Address - Fax:
Practice Address - Street 1:4309 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2842
Practice Address - Country:US
Practice Address - Phone:925-356-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist