Provider Demographics
NPI:1518330109
Name:SUAREZ, JULIE ANN SANTIAGO (RPH)
Entity type:Individual
Prefix:MRS
First Name:JULIE ANN
Middle Name:SANTIAGO
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2724
Mailing Address - Country:US
Mailing Address - Phone:925-689-2398
Mailing Address - Fax:925-798-2899
Practice Address - Street 1:2677 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2724
Practice Address - Country:US
Practice Address - Phone:925-689-2398
Practice Address - Fax:925-798-2899
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist