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NPI Code Detail

MEDICARE: SHELLEY SOUSA ALBERT PHARM.D.

MEDICARE: SHELLEY SOUSA ALBERT PHARM.D.
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
1183500000XPharmacist51168CA

General Provider Information

NPI Number : 1689983769
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY SOUSA ALBERT PHARM.D.
Provider Business Mailing Address
First Line : 760 COUNTRY CLUB DR
Second Line :
City : CARMEL VALLEY
State : CA
Zip : 93924-9559
Country : US
Telephone Number : 831-659-1210
Fax Number :
Provider Business Practice Location Address
First Line : 133 15TH ST
Second Line :
City : PACIFIC GROVE
State : CA
Zip : 93950-2746
Country : US
Telephone Number : 831-373-1225
Fax Number : 831-373-3705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2010
Last Update Date : 10/06/2010

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Directions to “ SHELLEY SOUSA ALBERT PHARM.D.” Practice Location

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