Provider Demographics
NPI:1548668478
Name:LAMSON, CHERIE LOU FAJARDO
Entity type:Individual
Prefix:
First Name:CHERIE LOU
Middle Name:FAJARDO
Last Name:LAMSON
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 1:2305 THEATHRE DR
Mailing Address - Street 2:TARGET PHARMACY
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446
Mailing Address - Country:US
Mailing Address - Phone:805-227-4304
Mailing Address - Fax:805-769-9172
Practice Address - Street 1:2305 THEATHRE DR
Practice Address - Street 2:TARGET PHARMACY
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446
Practice Address - Country:US
Practice Address - Phone:805-227-4304
Practice Address - Fax:805-769-9172
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist