Healthcare Provider Details

I. General information

NPI: 1821905365
Provider Name (Legal Business Name): JULLANA CHRISTINE COSIO CAPITULO PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 CAMPUS POINT DR
LA JOLLA CA
92093-1350
US

IV. Provider business mailing address

1985 ARBOR GLN
ESCONDIDO CA
92025-6661
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-5891
  • Fax:
Mailing address:
  • Phone: 760-215-1636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: