Healthcare Provider Details

I. General information

NPI: 1154236818
Provider Name (Legal Business Name): JAMIE ZAMUDIO CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE PEREZ CPHT

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 TOBIAS DR
CHULA VISTA CA
91911-4417
US

IV. Provider business mailing address

1405 TOBIAS DR
CHULA VISTA CA
91911-4417
US

V. Phone/Fax

Practice location:
  • Phone: 575-494-3190
  • Fax:
Mailing address:
  • Phone: 575-494-3190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number83542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: