Provider Demographics
NPI:1003621582
Name:TWEEDIE, LAUREN MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:TWEEDIE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:GORDON
Other - Last Name:TWEEDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1150A GUERRERO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2913
Mailing Address - Country:US
Mailing Address - Phone:760-877-9501
Mailing Address - Fax:
Practice Address - Street 1:2400 MOORPARK AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2631
Practice Address - Country:US
Practice Address - Phone:760-877-9501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist