Individual provider Active NPI

Sandra Beck-Atwater, RPH

  • Pharmacist
  • Lodi, CA
National Provider Identifier
1912375015
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH37857 Issued in CA
Practice address
2415 W Vine St
Suite 104B
Lodi, CA 95242-3731
Phone
(209) 333-3009
NPI assigned
Sep 4, 2015
Last updated
Sep 4, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH37857 CA Primary

Addresses

Primary practice location

2415 W Vine St
Suite 104B
Lodi, CA 95242-3731

Mailing address

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 339-7555

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

LicenseStateTypeSpecialty
RPH37857CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lodi Memorial Hospital Association Inc Past Accepting new patients
Lodi Memorial Hospital Association Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1912375015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-339-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 W VINE ST",
            "address_2": "SUITE 104B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423731",
            "telephone_number": "209-333-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK-ATWATER",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH37857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.