Healthcare Provider Details

I. General information

NPI: 1194645184
Provider Name (Legal Business Name): DENESSE JAVIER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 TERMINO AVE
LONG BEACH CA
90804-2104
US

IV. Provider business mailing address

7034 PENGUIN DR
BUENA PARK CA
90620-1306
US

V. Phone/Fax

Practice location:
  • Phone: 562-307-8099
  • Fax:
Mailing address:
  • Phone: 562-981-4225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: