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NPI Code Detail

MEDICARE: DR. MICHELLE EDWARDS ALLEN PHARMD, BCPS, FCCM,

MEDICARE: DR. MICHELLE EDWARDS ALLEN PHARMD, BCPS, FCCM,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist55888CA
21835P1200XPharmacotherapy Pharmacist12974AZ
31835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist10053CA

General Provider Information

NPI Number : 1174695944
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE EDWARDS ALLEN PHARMD, BCPS, FCCM,
Provider Business Mailing Address
First Line : 416 WEST ST
Second Line :
City : SEBASTOPOL
State : CA
Zip : 95472-3715
Country : US
Telephone Number : 707-819-6401
Fax Number :
Provider Business Practice Location Address
First Line : SUTTER SANTA ROSA REGIONAL HOSPITAL DEPT. OF PHARMACY
Second Line : 30 MARK WEST SPRINGS ROAD
City : SANTA ROSA
State : CA
Zip : 95403-1436
Country : US
Telephone Number : 707-576-4340
Fax Number : 707-541-9120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 04/02/2020

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