Provider Demographics
NPI:1861197329
Name:ALSAFFAR, YASAMEEN RAAD NAJI (RPH)
Entity type:Individual
Prefix:
First Name:YASAMEEN
Middle Name:RAAD NAJI
Last Name:ALSAFFAR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 CRATER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-1972
Mailing Address - Country:US
Mailing Address - Phone:916-627-6619
Mailing Address - Fax:
Practice Address - Street 1:6169 CRATER LAKE DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-1972
Practice Address - Country:US
Practice Address - Phone:916-627-6619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH87569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist