Provider Demographics
NPI:1356011407
Name:BEE, VIVIAN MICHELLE
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:MICHELLE
Last Name:BEE
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 1:3883 JERSEY RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-6139
Mailing Address - Country:US
Mailing Address - Phone:510-309-4777
Mailing Address - Fax:
Practice Address - Street 1:3970 RIVERMARK PLZ
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-4155
Practice Address - Country:US
Practice Address - Phone:408-855-0985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist