Active NPI
Jocelyn Rebecca Fernandez
- Pharmacy Technician
- Port Arthur, TX
National Provider Identifier
1194318816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 277375
- Practice address
- 4930 Gulfway Dr
Port Arthur, TX 77642-1722 - Phone
- (409) 982-1654
- NPI assigned
- Feb 12, 2021
- Last updated
- Feb 12, 2021
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 277375 | TX | Primary |
Addresses
Primary practice location
4930 Gulfway Dr
Port Arthur, TX 77642-1722
Mailing address
4930 Gulfway Dr
Port Arthur, TX 77642-1722
Phone (409) 982-1654
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277375 | TX | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1194318816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4930 GULFWAY DR",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776421722",
"telephone_number": "409-982-1654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4930 GULFWAY DR",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776421722",
"telephone_number": "409-982-1654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "JOCELYN",
"middle_name": "REBECCA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-12",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "TX",
"license": "277375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Arthur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.