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General NPI Number Information
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NPI Number | 1134512742
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Entity Type | Individual
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Provider Name | JENNIFER GLASSMAN
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Gender | Female
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Dates
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Enumeration Date | 03/07/2015
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Last Update Date | 03/07/2015
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Provider Practice Location Address
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Address Line | 4247 S MOONEY BLVD
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City | VISALIA
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State | CA
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Zip | 93277-9146
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Country | US
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Telephone | 559-749-0748
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Fax |
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Provider Business Mailing Address
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Address Line | 2014 1/2 VOORHEES AVE
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City | REDONDO BEACH
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State | CA
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Zip | 90278-2329
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Country | US
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Telephone | 310-804-9490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 72379
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License Number State | CA
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