Active NPI
Rebecca Kaneshiro-Pacheco
- Pharmacist
- Jackson, CA
National Provider Identifier
1194267823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57766
- Practice address
- 12110 Industry Blvd
Jackson, CA 95642-9373 - Phone
- (209) 257-0786
- NPI assigned
- Nov 11, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 57766 | CA | Primary |
Addresses
Primary practice location
12110 Industry Blvd
Jackson, CA 95642-9373
Mailing address
12110 Industry Blvd
Jackson, CA 95642-9373
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478822400000",
"number": "1194267823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12110 INDUSTRY BLVD",
"city": "JACKSON",
"state": "CA",
"postal_code": "956429373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12110 INDUSTRY BLVD",
"city": "JACKSON",
"state": "CA",
"postal_code": "956429373",
"telephone_number": "209-257-0786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANESHIRO-PACHECO",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-11",
"last_updated": "2016-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.