Provider Demographics
NPI:1124772173
Name:SOGATA, ZENIA MAYA
Entity type:Individual
Prefix:
First Name:ZENIA
Middle Name:MAYA
Last Name:SOGATA
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 1:19359 ANDRADA DR
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3102
Mailing Address - Country:US
Mailing Address - Phone:661-313-9673
Mailing Address - Fax:
Practice Address - Street 1:2636 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5106
Practice Address - Country:US
Practice Address - Phone:916-485-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist