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NPI Code Detail

MEDICARE: JESSICA JALISE VALENZUELA PHARM.D.

MEDICARE:   JESSICA JALISE VALENZUELA  PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS022197AZ

General Provider Information

NPI Number : 1124577515
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JALISE VALENZUELA PHARM.D.
Provider Business Mailing Address
First Line : 8862 W MYRTLE AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85305-6934
Country : US
Telephone Number : 480-206-3712
Fax Number :
Provider Business Practice Location Address
First Line : 6601 W INDIAN SCHOOL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85033-3339
Country : US
Telephone Number : 623-846-0622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2016
Last Update Date : 09/26/2016

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Directions to “ JESSICA JALISE VALENZUELA PHARM.D.” Practice Location

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