Provider Demographics
NPI:1669682415
Name:EMBREY, BECKY (PHARMD)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:EMBREY
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:PO BOX 730501
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95173-0501
Mailing Address - Country:US
Mailing Address - Phone:510-875-9351
Mailing Address - Fax:
Practice Address - Street 1:1320 W HILLSDALE BLVD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-3125
Practice Address - Country:US
Practice Address - Phone:650-570-6094
Practice Address - Fax:650-570-6460
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 51709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist