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General NPI Number Information
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NPI Number | 1225504160
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Entity Type | Individual
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Provider Name | JESSICA M. LOUIE PHARMD, APH, BCCCP
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Gender | Female
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 10/18/2018
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Provider Practice Location Address
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Address Line | 590 NORTH VERMONT AVENUE, SUITE 334
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City | LOS ANGELES
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State | CA
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Zip | 90004
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Country | US
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Telephone | 209-683-4009
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Fax |
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Provider Business Mailing Address
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Address Line | 18336 SOLEDAD CANYON RD UNIT 1684
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City | CANYON COUNTRY
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State | CA
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Zip | 91386-7041
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Country | US
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Telephone |
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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 | 69174
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | 7150304
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 10114
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License Number State | CA
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