Healthcare Provider Details

I. General information

NPI: 1477272953
Provider Name (Legal Business Name): JERMAINE KRYSTY REYES ESQUIVEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 PANAMA LN
BAKERSFIELD CA
93313-3631
US

IV. Provider business mailing address

3301 PANAMA LN
BAKERSFIELD CA
93313-3631
US

V. Phone/Fax

Practice location:
  • Phone: 661-835-9383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH87794
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61302783
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: