MEDICARE: TRICIA JOY VENTENILLA

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	88856	CA

General Provider Information

NPI Number	:	1982479507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRICIA JOY VENTENILLA

Provider Business Mailing Address
First Line	:	39 BELHAVEN AVE
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-3944
Country	:	US
Telephone Number	:	650-392-4910
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 W HILLSDALE BLVD
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-3125
Country	:	US
Telephone Number	:	650-570-6094
Fax Number	:

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

Provider Enumeration Date	:	11/24/2023
Last Update Date	:	11/24/2023

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Directions to “ TRICIA JOY VENTENILLA ” Practice Location

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