Active NPI
Deepa Reddy Annavaram, RPH
- Pharmacist
- San Ramon, CA
National Provider Identifier
1245888247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63875
- Practice address
- 2455 San Ramon Valley Blvd
San Ramon, CA 94583-1601 - Phone
- (925) 820-7325
- NPI assigned
- Sep 3, 2019
- Last updated
- Sep 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63875 | CA | Primary |
Addresses
Primary practice location
2455 San Ramon Valley Blvd
San Ramon, CA 94583-1601
Mailing address
2502 Avery Way
Dublin, CA 94568-4346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63875 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1245888247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2502 AVERY WAY",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945684346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2455 SAN RAMON VALLEY BLVD",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945831601",
"telephone_number": "925-820-7325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANNAVARAM",
"first_name": "DEEPA",
"middle_name": "REDDY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.