Provider Demographics
NPI:1942654223
Name:WONG KAPLAN, BECKY
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:
Last Name:WONG KAPLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:K
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:801 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1250
Mailing Address - Country:US
Mailing Address - Phone:530-345-1363
Mailing Address - Fax:
Practice Address - Street 1:801 EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-345-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist