Individual provider Active NPI

Yancy Gadra Ram, PHARMD

  • Pharmacist
  • Lathrop, CA
National Provider Identifier
1629785332
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87022 Issued in CA
Practice address
14780 S Harlan Rd
Lathrop, CA 95330-9719
Phone
(209) 858-2801
NPI assigned
Nov 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87022 CA Primary

Addresses

Primary practice location

14780 S Harlan Rd
Lathrop, CA 95330-9719

Mailing address

563 Bramblewood Ave
Lathrop, CA 95330-9369
Phone (209) 808-3513

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
87022CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1629785332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 BRAMBLEWOOD AVE",
            "city": "LATHROP",
            "state": "CA",
            "postal_code": "953309369",
            "telephone_number": "209-808-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14780 S HARLAN RD",
            "city": "LATHROP",
            "state": "CA",
            "postal_code": "953309719",
            "telephone_number": "209-858-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAM",
        "first_name": "YANCY",
        "middle_name": "GADRA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lathrop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.