Provider Demographics
NPI:1689120040
Name:SHEN, FELICITY (PHARMD)
Entity Type:Individual
Prefix:
First Name:FELICITY
Middle Name:
Last Name:SHEN
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 1:3855 HEALTH SCIENCES DR
Mailing Address - Street 2:ROOM 1036; MAIL CODE 0845
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-1503
Mailing Address - Country:US
Mailing Address - Phone:858-822-6091
Mailing Address - Fax:858-822-6092
Practice Address - Street 1:3855 HEALTH SCIENCES DR
Practice Address - Street 2:ROOM 1036; MAIL CODE 0845
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-1503
Practice Address - Country:US
Practice Address - Phone:858-822-6091
Practice Address - Fax:858-822-6092
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist