Healthcare Provider Details

I. General information

NPI: 1598890428
Provider Name (Legal Business Name): CATHERINE ANN BEAUCHAMP PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 SHATTUCK AVE
BERKELEY CA
94709-1611
US

IV. Provider business mailing address

PO BOX 2203
CASTRO VALLEY CA
94546-0203
US

V. Phone/Fax

Practice location:
  • Phone: 510-549-9201
  • Fax: 510-549-9204
Mailing address:
  • Phone: 510-909-6986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH40207
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: