MEDICARE: DR. JONICE LORIN TENETTE-ANDERSON 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
1	183500000X	Pharmacist	31110	CA

General Provider Information

NPI Number	:	1629354675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONICE LORIN TENETTE-ANDERSON PHARM.D.

Provider Business Mailing Address
First Line	:	1276 RUBIO VISTA RD
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-1534
Country	:	US
Telephone Number	:	323-684-4392
Fax Number	:

Provider Business Practice Location Address
First Line	:	1276 RUBIO VISTA RD
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-1534
Country	:	US
Telephone Number	:	323-684-4392
Fax Number	:

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

Provider Enumeration Date	:	10/21/2011
Last Update Date	:	10/27/2014

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