Provider Demographics
NPI:1801179122
Name:GAYAGOY, MARIA JOCELYN GOZAR (BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:MARIA JOCELYN
Middle Name:GOZAR
Last Name:GAYAGOY
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:GOZAR
Other - Last Name:GAYAGOY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:29 E MARCH LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5871
Mailing Address - Country:US
Mailing Address - Phone:209-478-0891
Mailing Address - Fax:209-478-1168
Practice Address - Street 1:29 E MARCH LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5871
Practice Address - Country:US
Practice Address - Phone:209-478-0891
Practice Address - Fax:209-478-1168
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist