Provider Demographics
NPI:1649395328
Name:AVNET, PATRICIA (PHARM TECH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:AVNET
Suffix:
Gender:F
Credentials:PHARM TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17939 CHATSWORTH ST
Mailing Address - Street 2:#522
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14124 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-8049
Practice Address - Country:US
Practice Address - Phone:818-367-5939
Practice Address - Fax:818-362-2179
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21344183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician