Healthcare Provider Details

I. General information

NPI: 1336756022
Provider Name (Legal Business Name): HANNAH MINETTE ROQUE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2020
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 JOHNSON DR
PLEASANTON CA
94588-8005
US

IV. Provider business mailing address

7200 JOHNSON DR
PLEASANTON CA
94588-8005
US

V. Phone/Fax

Practice location:
  • Phone: 925-475-4010
  • Fax: 925-475-4001
Mailing address:
  • Phone: 925-475-4010
  • Fax: 925-475-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83267
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number83267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: