Provider Demographics
NPI:1396611869
Name:ABOUSAUD, ASEALA (PHARMD, BCOP, APH)
Entity type:Individual
Prefix:
First Name:ASEALA
Middle Name:
Last Name:ABOUSAUD
Suffix:
Gender:F
Credentials:PHARMD, BCOP, APH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:177 LA CASA VIA STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-6101
Practice Address - Country:US
Practice Address - Phone:925-692-5647
Practice Address - Fax:925-692-5908
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA907321835P0018X, 1835P1200X, 1835P2201X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care