Roua H Aboukhadijeh, PHARMD
Individual provider Active NPI Pharmacist · Riverside, CA
NPI 1972197861 · NPPES record last updated Feb 28, 2021
Key facts
- NPI
- 1972197861
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 83584 (CA)
- Practice address
- 6215 Riverside Ave
Riverside, CA 92506-2179 - Phone
- (949) 505-2484
- NPI assigned
- Feb 22, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83584 | CA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 83584 | CA | Yes |
Addresses
Primary practice location
6215 Riverside Ave
Riverside, CA 92506-2179
Mailing address
13046 Empty Saddle CT
Corona, CA 92883-6306
Phone (949) 505-2484
Other practice location 1
13046 Empty Saddle Ct
Corona, CA 92883-6306
Phone (949) 505-2484
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2021. 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.