Provider Demographics
NPI:1316457500
Name:MARCELINO, GRETCHEN PASION (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:PASION
Last Name:MARCELINO
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ROSEVILLE PKWY APT 1111
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-4110
Mailing Address - Country:US
Mailing Address - Phone:808-203-9683
Mailing Address - Fax:
Practice Address - Street 1:9479 MADISON AVE
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2092
Practice Address - Country:US
Practice Address - Phone:916-987-0342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80226183500000X
NY063451183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist