Provider Demographics
NPI:1861772659
Name:DEUKMEDJIAN, ANNE NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:NICOLE
Last Name:DEUKMEDJIAN
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 1:512 N VENTU PARK RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2709
Mailing Address - Country:US
Mailing Address - Phone:805-262-3413
Mailing Address - Fax:
Practice Address - Street 1:2001 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2681
Practice Address - Country:US
Practice Address - Phone:805-981-9606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH63389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist