Active NPI
Janice Hyejin Park, PHARMD
- Pharmacist
- Fullerton, CA
National Provider Identifier
1144794264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79792
- Practice address
- 1421 Manhattan Ave
Fullerton, CA 92831-5221 - Phone
- (657) 243-0809
- NPI assigned
- Jan 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 79792 | CA | Primary |
Addresses
Primary practice location
1421 Manhattan Ave
Fullerton, CA 92831-5221
Mailing address
16040 Sierra Pass Way
Hacienda Heights, CA 91745-6544
Phone (909) 609-4088
Other practice location 1
16040 Sierra Pass Way
Hacienda Heights, CA 91745
Phone (909) 609-4088
Other names 1
- Janice Park
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79792 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1144794264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16040 SIERRA PASS WAY",
"city": "HACIENDA HEIGHTS",
"state": "CA",
"postal_code": "917456544",
"telephone_number": "909-609-4088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 MANHATTAN AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928315221",
"telephone_number": "657-243-0809"
}
],
"practiceLocations": [
{
"address_1": "16040 Sierra Pass Way",
"address_purpose": "LOCATION",
"city": "Hacienda Heights",
"state": "CA",
"postal_code": "91745",
"country_code": "US",
"telephone_number": "909-609-4088",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "JANICE",
"middle_name": "HYEJIN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-12",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANICE",
"last_name": "PARK",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.