Healthcare Provider Details

I. General information

NPI: 1376451310
Provider Name (Legal Business Name): ALAA AL JAWABRA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 W RUMBLE RD APT J6
MODESTO CA
95350-0190
US

IV. Provider business mailing address

2800 W RUMBLE RD APT J6
MODESTO CA
95350-0190
US

V. Phone/Fax

Practice location:
  • Phone: 209-702-3548
  • Fax:
Mailing address:
  • Phone: 209-702-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH92930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: