Provider Demographics
NPI:1700142254
Name:LOTZ-WEINER, SANDRA (RPH)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LOTZ-WEINER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:LOTZ-WEINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2000 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAND CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93955-3150
Mailing Address - Country:US
Mailing Address - Phone:831-393-1400
Mailing Address - Fax:831-393-1420
Practice Address - Street 1:555 CARMEL RANCHO BLVD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8708
Practice Address - Country:US
Practice Address - Phone:831-624-7173
Practice Address - Fax:831-624-7348
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist