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General NPI Number Information
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NPI Number | 1558842062
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Entity Type | Individual
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Provider Name | JENNIFER MOSELY
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 701 PORTOLA DR
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City | SAN FRANCISCO
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State | CA
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Zip | 94127-1209
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Country | US
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Telephone | 415-504-6043
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 FILLMORE ST APT 1A
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1853
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Country | US
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Telephone | 972-890-5954
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 78169
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License Number State | CA
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