Provider Demographics
NPI:1871871368
Name:DEA, WENDY W (PHARM D)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:W
Last Name:DEA
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:PO BOX 4403
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-0403
Mailing Address - Country:US
Mailing Address - Phone:650-917-1959
Mailing Address - Fax:
Practice Address - Street 1:150 LAWRENCE STATION RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5309
Practice Address - Country:US
Practice Address - Phone:408-730-0424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist