Provider Demographics
NPI:1962934190
Name:WIEBE HOWARD, VALERIE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:WIEBE HOWARD
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:ONE SHIELDS AVE RM 1061
Mailing Address - Street 2:UNIVERSITY OF CA, DAVIS
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-8747
Mailing Address - Country:US
Mailing Address - Phone:530-752-0187
Mailing Address - Fax:530-754-2260
Practice Address - Street 1:ONE SHIELDS AVE, ROOM 1061
Practice Address - Street 2:UNIVERSITY OF CA, DAVIS
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-8747
Practice Address - Country:US
Practice Address - Phone:530-752-0187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH436241835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care