Healthcare Provider Details

I. General information

NPI: 1376190116
Provider Name (Legal Business Name): JESSEL REMOROZA VILLEGAS PHARMD, BCCCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 06/12/2021
Certification Date: 06/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLZ
LOS ANGELES CA
90095-5504
US

IV. Provider business mailing address

PO BOX 7667
ALHAMBRA CA
91802-7667
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-9111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77166
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number77166
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: