Provider Demographics
NPI:1881001584
Name:RICHTER, PAMELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:RICHTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:WYCKOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8944 HIGHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1426
Mailing Address - Country:US
Mailing Address - Phone:619-460-3969
Mailing Address - Fax:
Practice Address - Street 1:8944 HIGHWOOD DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1426
Practice Address - Country:US
Practice Address - Phone:619-460-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA434321835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist