Provider Demographics
NPI:1366545915
Name:VANMATER, BARBARA ELLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ELLEN
Last Name:VANMATER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 BEVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-3070
Mailing Address - Country:US
Mailing Address - Phone:559-225-6100
Mailing Address - Fax:559-241-6496
Practice Address - Street 1:3220 SW 96TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3043
Practice Address - Country:US
Practice Address - Phone:305-575-3122
Practice Address - Fax:305-575-3386
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458441835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist