Healthcare Provider Details

I. General information

NPI: 1598765695
Provider Name (Legal Business Name): MONICA LAYNE SAKASEGAWA PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONICA LAYNE FERRONI-SAKASEGAWA PHARM.D.

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3026 XENOPHON ST
SAN DIEGO CA
92106-1536
US

IV. Provider business mailing address

3026 XENOPHON ST
SAN DIEGO CA
92106-1536
US

V. Phone/Fax

Practice location:
  • Phone: 619-985-5339
  • Fax:
Mailing address:
  • Phone: 619-985-5339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2343
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: