Provider Demographics
NPI:1891082855
Name:UYEDA, KIMBERLY E (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:UYEDA
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 1:7505 LAGUNA BLVD
Mailing Address - Street 2:T-1025
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5061
Mailing Address - Country:US
Mailing Address - Phone:916-683-2936
Mailing Address - Fax:916-683-2936
Practice Address - Street 1:7505 LAGUNA BLVD
Practice Address - Street 2:T-1025
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5061
Practice Address - Country:US
Practice Address - Phone:916-683-2936
Practice Address - Fax:916-683-2936
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist