Healthcare Provider Details

I. General information

NPI: 1356858740
Provider Name (Legal Business Name): DENA WESTPHALEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2018
Last Update Date: 01/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

429 CLIFTON ST
OAKLAND CA
94618-1167
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-4800
  • Fax:
Mailing address:
  • Phone: 415-699-0527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number77109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: