Provider Demographics
NPI:1962785170
Name:SHAGRIN, KAREN M (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:SHAGRIN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2035
Mailing Address - Country:US
Mailing Address - Phone:925-933-0307
Mailing Address - Fax:925-933-0559
Practice Address - Street 1:2900 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-2035
Practice Address - Country:US
Practice Address - Phone:925-933-0307
Practice Address - Fax:925-933-0559
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA593031835P0018X
OH032131251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist