Provider Demographics
NPI:1487886396
Name:CARR-LOPEZ, SIAN MARIE (PHARM,D)
Entity type:Individual
Prefix:
First Name:SIAN
Middle Name:MARIE
Last Name:CARR-LOPEZ
Suffix:
Gender:F
Credentials:PHARM,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 QUALITY DR
Mailing Address - Street 2:KAISER PERMANENTE MEDICAL CENTER
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9494
Mailing Address - Country:US
Mailing Address - Phone:707-624-1366
Mailing Address - Fax:707-624-2071
Practice Address - Street 1:1 QUALITY DR
Practice Address - Street 2:KAISER PERMANENTE MEDICAL CENTER
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-9494
Practice Address - Country:US
Practice Address - Phone:707-624-1366
Practice Address - Fax:707-624-2071
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH39855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist