Healthcare Provider Details

I. General information

NPI: 1114231131
Provider Name (Legal Business Name): JOSEFINA ENCARNACION MOJICA PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14515 MOJAVE DR
VICTORVILLE CA
92394-6762
US

IV. Provider business mailing address

12950 BLAIR ST
VICTORVILLE CA
92392-7951
US

V. Phone/Fax

Practice location:
  • Phone: 760-955-7898
  • Fax:
Mailing address:
  • Phone: 760-948-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: