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General NPI Number Information
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NPI Number | 1376006726
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Entity Type | Individual
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Provider Name | JACQUELINE DAIR AULD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 775 TUCKER RD
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City | TEHACHAPI
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State | CA
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Zip | 93561-2502
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Country | US
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Telephone | 661-823-7094
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Fax |
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Provider Business Mailing Address
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Address Line | 18751 HATTERAS ST UNIT 14
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City | TARZANA
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State | CA
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Zip | 91356-1487
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Country | US
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Telephone | 818-903-1023
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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 | RPH80191
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License Number State | CA
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