Healthcare Provider Details

I. General information

NPI: 1558611962
Provider Name (Legal Business Name): MELISSA E JUMP PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 S BRISTOL ST STE 110
SANTA ANA CA
92704-6210
US

IV. Provider business mailing address

26 CALLE BOVEDA
SAN CLEMENTE CA
92673-6806
US

V. Phone/Fax

Practice location:
  • Phone: 323-695-6024
  • Fax:
Mailing address:
  • Phone: 760-805-9272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61687
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: