Provider Demographics
NPI:1639600315
Name:LAM, STEPHANIE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 ALTURAS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3001
Mailing Address - Country:US
Mailing Address - Phone:408-871-6339
Mailing Address - Fax:
Practice Address - Street 1:220 E HACIENDA AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-6617
Practice Address - Country:US
Practice Address - Phone:408-871-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH51343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist