Healthcare Provider Details

I. General information

NPI: 1942500012
Provider Name (Legal Business Name): SHAUNA MARIE WEAVER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2010
Last Update Date: 10/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MID VALLEY CTR
CARMEL CA
93923-8500
US

IV. Provider business mailing address

PO BOX 1212
PEBBLE BEACH CA
93953-1212
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-1620
  • Fax:
Mailing address:
  • Phone: 831-915-0407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: