Stephanie Elizabeth Quan

Primary specialty

PharmacistTaxonomy code 183500000X

License

83074 Issued in CA

Practice address

2808 Country Club Blvd
Stockton, CA 95204-3957

Phone

(209) 461-5560

NPI assigned

Aug 19, 2020

Last updated

Aug 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safeway Inc

  dba Safeway Pharmacy #1769

  • Community/Retail Pharmacy
  • Stockton, CA
  • NPI 1629014261
  NPD (past)
• Safeway Inc

  dba Safeway Pharmacy #0209

  • Community/Retail Pharmacy
  • Queen Creek, AZ
  • NPI 1730040973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1144832288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 COUNTRY CLUB BLVD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 COUNTRY CLUB BLVD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043957",
            "telephone_number": "209-461-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "83074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faye Alvarez Quadra
• Quail Lake Holdings LLC (Crystal Creek Post-Acute)
• Quail Lakes Dermatology Medical Associates, Inc.
• Amber Rae Qualls
• Quan Vo Anh Nguyen DDS Inc (Innovation Dental)
• Lan Ngoc Quang, M.D.
• Quantum Medical Radiology of California, PC
• Alicia Marie Queirolo, LPT
• Jemielleann Quero
• Alycia Quezada

• Pharmacist in Stockton, CA
• Providers in Stockton, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.