Healthcare Provider Details

I. General information

NPI: 1316160609
Provider Name (Legal Business Name): JOLETTA DENISE CASSEL PHARM TECH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 E CARSON ST
CARSON CA
90745-2720
US

IV. Provider business mailing address

645 E CARSON ST
CARSON CA
90745-2720
US

V. Phone/Fax

Practice location:
  • Phone: 310-830-8927
  • Fax: 310-830-2979
Mailing address:
  • Phone: 310-830-8927
  • Fax: 310-830-2979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number329307
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number8623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: