Yamam Aldakkak, RPH
Individual provider Active NPI Pharmacist · Tracy, CA
NPI 1831896687 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1831896687
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 87152 (CA)
- Practice address
- 1830 W 11TH St
Tracy, CA 95376-3736 - Phone
- (209) 832-1498
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87152 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 87152 | CA | Yes |
Addresses
Primary practice location
1830 W 11TH St
Tracy, CA 95376-3736
Mailing address
2810 S Tracy Blvd
Tracy, CA 95377-8127
Phone (951) 824-4487
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87152 | Other | CA | RPH LICENSE NO. |
Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.