Provider Demographics
NPI:1639636350
Name:SHAKARIAN, PATRICIA (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SHAKARIAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9332 TECH CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2598
Mailing Address - Country:US
Mailing Address - Phone:916-857-7000
Mailing Address - Fax:
Practice Address - Street 1:9332 TECH CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2598
Practice Address - Country:US
Practice Address - Phone:916-857-7000
Practice Address - Fax:916-857-7040
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist