Provider Demographics
NPI:1255970323
Name:SPOONHOUR, DEBBIE JEAN (PHARMD)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:JEAN
Last Name:SPOONHOUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:JEAN
Other - Last Name:SPOONHOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2416 MOONLIGHT GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-3847
Mailing Address - Country:US
Mailing Address - Phone:760-492-3351
Mailing Address - Fax:
Practice Address - Street 1:6725 MESA RIDGE RD STE 230
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2925
Practice Address - Country:US
Practice Address - Phone:888-963-6544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA430511835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist