Provider Demographics
NPI:1609224468
Name:DOBLER-WILKES, DEANNA
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:DOBLER-WILKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 DEER VALLEY RD # 4216
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8577
Mailing Address - Country:US
Mailing Address - Phone:925-813-3956
Mailing Address - Fax:
Practice Address - Street 1:5601 DEER VALLEY RD # 4216
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8577
Practice Address - Country:US
Practice Address - Phone:925-813-3956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist