Provider Demographics
NPI:1306270921
Name:REDDY, SWAPNA (PHD)
Entity type:Individual
Prefix:
First Name:SWAPNA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 TAFT HWY SPC 53
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-6277
Mailing Address - Country:US
Mailing Address - Phone:760-881-0417
Mailing Address - Fax:
Practice Address - Street 1:2628 MT VERNON
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-6277
Practice Address - Country:US
Practice Address - Phone:661-871-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist