Provider Demographics
NPI:1689064198
Name:LEAHY, ANGELA DAI ZOVI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAI ZOVI
Last Name:LEAHY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:LUCIANA
Other - Last Name:DAI ZOVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3558 DORENA PL
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-6237
Mailing Address - Country:US
Mailing Address - Phone:916-371-3328
Mailing Address - Fax:916-371-3328
Practice Address - Street 1:3558 DORENA PL
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-6237
Practice Address - Country:US
Practice Address - Phone:916-371-3328
Practice Address - Fax:916-371-3328
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist