Provider Demographics
NPI:1255994893
Name:OUYANG, SHERRIE XIANG
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:XIANG
Last Name:OUYANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14869 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2921
Mailing Address - Country:US
Mailing Address - Phone:510-351-1492
Mailing Address - Fax:510-351-5972
Practice Address - Street 1:14869 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2921
Practice Address - Country:US
Practice Address - Phone:510-351-1492
Practice Address - Fax:510-351-5972
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist