Provider Demographics
NPI:1053976977
Name:SHEETS, REBECCA (PHARM D)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SHEETS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6654
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95502-6654
Mailing Address - Country:US
Mailing Address - Phone:805-570-5246
Mailing Address - Fax:
Practice Address - Street 1:2280 HARRISON AVE STE B
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3200
Practice Address - Country:US
Practice Address - Phone:707-443-9371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12300183500000X
CA65368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist