Provider Demographics
NPI:1871371021
Name:GRAY, ERICA DESHAWN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:DESHAWN
Last Name:GRAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 E LELAND RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4911
Mailing Address - Country:US
Mailing Address - Phone:925-432-9770
Mailing Address - Fax:925-432-9774
Practice Address - Street 1:361 E LELAND RD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4911
Practice Address - Country:US
Practice Address - Phone:925-432-9770
Practice Address - Fax:925-432-9774
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist