Healthcare Provider Details

I. General information

NPI: 1407773880
Provider Name (Legal Business Name): JESSICA ALEXIS OKOMURA BERNAL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 WILLIAM PENN HWY
PALMER TOWNSHIP PA
18045-5222
US

IV. Provider business mailing address

401 ROBERT MORRIS BLVD APT 412
ALLENTOWN PA
18104-4576
US

V. Phone/Fax

Practice location:
  • Phone: 610-252-3538
  • Fax:
Mailing address:
  • Phone: 925-917-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460313
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: