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Individual

STACY ANN SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
505 CITY PKWY W, ORANGE, CA 92868-2924
(657) 235-6778
(714) 338-3132
Mailing address
505 CITY PKWY W, ORANGE, CA 92868-2924
(657) 235-6778
(714) 338-3132

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
520107010118472
PTCB
CA
Enumeration date
11/07/2014
Last updated
11/07/2014
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