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General NPI Number Information
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NPI Number | 1730835984
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Entity Type | Individual
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Provider Name | JELLANE M EMESES
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Gender | Female
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 1605 S SAN JACINTO AVE
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City | SAN JACINTO
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State | CA
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Zip | 92583-5181
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Country | US
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Telephone | 951-654-4734
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Fax | 951-654-9284
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Provider Business Mailing Address
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Address Line | 24034 CROWNED PARTRIDGE LN
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City | MURRIETA
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State | CA
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Zip | 92562-4694
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Country | US
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Telephone | 951-905-8073
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | TCH35653
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License Number State | CA
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