Provider Demographics
NPI:1285917443
Name:KAYE, ADAM (PHARMD,FASCP,FCPHA)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:KAYE
Suffix:
Gender:M
Credentials:PHARMD,FASCP,FCPHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7502
Mailing Address - Street 2:2488 N CALIFORNIA ST, STOCKTON,CA 95204
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0502
Mailing Address - Country:US
Mailing Address - Phone:209-946-3278
Mailing Address - Fax:
Practice Address - Street 1:3131 W HAMMER LN
Practice Address - Street 2:ALTERNATE: 2488 N CALIFORNIA ST, STOCKTON,CA 95204
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-2747
Practice Address - Country:US
Practice Address - Phone:209-476-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48004183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist