Healthcare Provider Details

I. General information

NPI: 1386665941
Provider Name (Legal Business Name): PATRICIA LOUISE POOLE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA LOUISE WITHEROW

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 21ST ST
SACRAMENTO CA
95814-5216
US

IV. Provider business mailing address

569 MILLFRONT AVE
YUBA CITY CA
95991-8304
US

V. Phone/Fax

Practice location:
  • Phone: 916-914-6340
  • Fax:
Mailing address:
  • Phone: 530-755-2836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number42081
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: