STOCKTON PHARMACY – NPI #1417891953
Pharmacy

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

Health Care Provider Taxonomy Code for Pharmacy

STOCKTON PHARMACY is a pharmacy located in STOCKTON, CA. NPPES recently assigned the NPI number 1417891953 to STOCKTON PHARMACY on April 15, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 3336C0004X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Compounding Pharmacy

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STOCKTON PHARMACY below.

NPI Profile for
STOCKTON PHARMACY

NPI Number
1417891953
Enumeration Date

(about 8 weeks ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STOCKTON PHARMACY
Primary location
1140 W HAMMER LN # D
STOCKTON, CA 95209-3011
Phone: (209) 395-0555 Fax: (209) 451-3635
Mailing address
Same as primary location
Organization Subpart
Yes - STOCKTON PHARMACY is subpart of another organization.
Authorized Official
PRATAP ANNE
PHARMACY DIRECTOR
Phone: (209) 395-0555
Updated
Certification Date
Apr 15, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for STOCKTON PHARMACY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherPHARMACY LICENSECA61500
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0004X
- Pharmacy / Compounding Pharmacy (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.