Provider Demographics
NPI:1649085184
Name:IYERE, PATIENCE
Entity type:Individual
Prefix:MRS
First Name:PATIENCE
Middle Name:
Last Name:IYERE
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 1:7640 W STOCKTON BLVD UNIT 278
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5460
Mailing Address - Country:US
Mailing Address - Phone:916-308-3790
Mailing Address - Fax:
Practice Address - Street 1:4331 ANTELOPE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95843-6022
Practice Address - Country:US
Practice Address - Phone:916-722-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist