Provider Demographics
NPI:1730408675
Name:COLEMAN, TERRI A (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:A
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:TERRI
Other - Middle Name:A
Other - Last Name:COYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:200 FAIRMOUNT AVE APT 318
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5811
Mailing Address - Country:US
Mailing Address - Phone:510-459-7629
Mailing Address - Fax:
Practice Address - Street 1:27 ORINDA WAY
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2538
Practice Address - Country:US
Practice Address - Phone:925-253-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist