Provider Demographics
NPI:1689040909
Name:SAQUETON, NICHOLE CUENCO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:CUENCO
Last Name:SAQUETON
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 6676
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-1676
Mailing Address - Country:US
Mailing Address - Phone:707-246-6460
Mailing Address - Fax:
Practice Address - Street 1:2680 REYNOLDS RANCH PKWY
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-6848
Practice Address - Country:US
Practice Address - Phone:209-366-7301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist