Provider Demographics
NPI:1962653741
Name:NAKU, FOLASHADE ANIKE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:FOLASHADE
Middle Name:ANIKE
Last Name:NAKU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 W PINTAIL WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-8204
Mailing Address - Country:US
Mailing Address - Phone:408-834-6684
Mailing Address - Fax:
Practice Address - Street 1:1167 S KING RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2144
Practice Address - Country:US
Practice Address - Phone:408-834-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567741835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist