Jouston Taylor Gonzales

Individual provider Active NPI Pharmacy Technician · Exeter, CA

NPI 1164199733 · NPPES record last updated Aug 23, 2021

Key facts

NPI
1164199733
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
138349 (CA)
Practice address
1051 W Visalia Rd
Exeter, CA 93221-2202
Phone
(559) 592-4901
Fax
(559) 592-6538
NPI assigned
Aug 23, 2021
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
138349CAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past
since Aug 29, 2021
Accepting new patients
Thrifty Payless Inc Past
since Aug 29, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 138349 CA Yes

Addresses

Primary practice location

1051 W Visalia Rd
Exeter, CA 93221-2202

Mailing address

474 1St St
Lindsay, CA 93247-2104
Phone (559) 667-1040

Other providers in Exeter, CA

All providers in Exeter, CA · Pharmacy Technician in California

Sources for this page

Verify at the official NPI Registry.