Provider Demographics
NPI:1922832443
Name:DE PERIO, PATRICIA JANINE REYES (PHARM D)
Entity type:Individual
Prefix:
First Name:PATRICIA JANINE
Middle Name:REYES
Last Name:DE PERIO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9523 LITTLE RAPIDS WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7802
Mailing Address - Country:US
Mailing Address - Phone:858-947-8803
Mailing Address - Fax:
Practice Address - Street 1:2425 ALHAMBRA BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1955
Practice Address - Country:US
Practice Address - Phone:916-404-0022
Practice Address - Fax:916-404-0023
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH89691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist