Provider Demographics
NPI:1700208113
Name:BUKSA, JULIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BUKSA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 SPRUCEHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-3660
Mailing Address - Country:US
Mailing Address - Phone:661-589-1832
Mailing Address - Fax:
Practice Address - Street 1:1710 SPRUCEHAVEN ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-3660
Practice Address - Country:US
Practice Address - Phone:661-589-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist