MEDICARE: JENICA LEE PHARMD

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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	73411	CA

General Provider Information

NPI Number	:	1598410573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENICA LEE PHARMD

Provider Business Mailing Address
First Line	:	505 PARNASSUS AVE RM M39
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2204
Country	:	US
Telephone Number	:	415-514-8349
Fax Number	:	415-353-8548

Provider Business Practice Location Address
First Line	:	505 PARNASSUS AVE RM M39
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2204
Country	:	US
Telephone Number	:	415-514-8349
Fax Number	:	415-353-8548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2022
Last Update Date	:	06/16/2026

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