Provider Demographics
NPI:1295092294
Name:DYER, CINDY KA (PHARMD)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:KA
Last Name:DYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:KA
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8915 GERBER ROAD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829
Mailing Address - Country:US
Mailing Address - Phone:916-897-5010
Mailing Address - Fax:
Practice Address - Street 1:8915 GERBER ROAD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829
Practice Address - Country:US
Practice Address - Phone:916-897-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist