Healthcare Provider Details

I. General information

NPI: 1932456936
Provider Name (Legal Business Name): SUSAN BARNARD RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 CALIFORNIA AVE
SAND CITY CA
93955-3150
US

IV. Provider business mailing address

316 MID VALLEY CTR # 129
CARMEL CA
93923-8516
US

V. Phone/Fax

Practice location:
  • Phone: 831-583-9110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: