Provider Demographics
NPI:1801156922
Name:COELHO, MARIA MAGDALENA
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:MAGDALENA
Last Name:COELHO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:MAGDALENA
Other - Last Name:CALDEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:3778 REFLECTIONS DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7182
Mailing Address - Country:US
Mailing Address - Phone:925-485-1440
Mailing Address - Fax:
Practice Address - Street 1:1500 FIRST ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4302
Practice Address - Country:US
Practice Address - Phone:925-455-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist