Provider Demographics
NPI:1770868473
Name:DANCEY, MALISSA (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MALISSA
Middle Name:
Last Name:DANCEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 E CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1002
Mailing Address - Country:US
Mailing Address - Phone:530-221-5028
Mailing Address - Fax:530-221-8165
Practice Address - Street 1:980 E CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1002
Practice Address - Country:US
Practice Address - Phone:530-221-5028
Practice Address - Fax:530-221-8165
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist