Provider Demographics
NPI:1679178750
Name:SPENCER, CHINA ALENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHINA
Middle Name:ALENA
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHINA
Other - Middle Name:ALENA
Other - Last Name:RAUTIAINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4601 WHITE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:DENAIR
Mailing Address - State:CA
Mailing Address - Zip Code:95316-9358
Mailing Address - Country:US
Mailing Address - Phone:209-298-7201
Mailing Address - Fax:
Practice Address - Street 1:4601 WHITE ROCK AVE
Practice Address - Street 2:
Practice Address - City:DENAIR
Practice Address - State:CA
Practice Address - Zip Code:95316-9358
Practice Address - Country:US
Practice Address - Phone:209-298-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist