Healthcare Provider Details

I. General information

NPI: 1013286434
Provider Name (Legal Business Name): JESSICA BECK PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W TEHACHAPI BLVD
TEHACHAPI CA
93561-2559
US

IV. Provider business mailing address

1101 W TEHACHAPI BLVD
TEHACHAPI CA
93561-2559
US

V. Phone/Fax

Practice location:
  • Phone: 760-784-1011
  • Fax: 661-826-2502
Mailing address:
  • Phone: 760-784-1011
  • Fax: 661-826-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65811
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: