Provider Demographics
NPI:1598655391
Name:TATSUYAMA, KAYLIN EMIKO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAYLIN
Middle Name:EMIKO
Last Name:TATSUYAMA
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 1:4355 NIOBE CIR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-8043
Mailing Address - Country:US
Mailing Address - Phone:719-252-4574
Mailing Address - Fax:
Practice Address - Street 1:11975 EL CAMINO REAL STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2541
Practice Address - Country:US
Practice Address - Phone:866-701-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist