Provider Demographics
NPI:1972179810
Name:WELLS, SONYA LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:LEE
Last Name:WELLS
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 1:1407 HILLSIDE LN
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5889
Mailing Address - Country:US
Mailing Address - Phone:916-627-0228
Mailing Address - Fax:
Practice Address - Street 1:1407 HILLSIDE LN
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5889
Practice Address - Country:US
Practice Address - Phone:916-627-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH41039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist