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General NPI Number Information
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NPI Number | 1801399951
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Entity Type | Individual
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Provider Name | LYDDA SANTIAGO TOLENTINO RPH
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Gender | Female
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Dates
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Enumeration Date | 03/15/2018
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Last Update Date | 03/15/2018
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Provider Practice Location Address
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Address Line | 7700 EDGEWATER DR 220
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City | OAKLAND
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State | CA
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Zip | 94621
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Country | US
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Telephone | 510-878-7562
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Fax |
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Provider Business Mailing Address
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Address Line | 4555 THORNTON AVE APT 3
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City | FREMONT
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State | CA
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Zip | 94536-5641
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Country | US
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Telephone | 408-421-3597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 68965
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License Number State | CA
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