Active NPI
Jaevon Kai Miranda, PHARMD.
- Pharmacist
- Victorville, CA
National Provider Identifier
1205732526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 91341
- Practice address
- 16850 Bear Valley Rd
Victorville, CA 92395-5794 - Phone
- (760) 241-8000
- NPI assigned
- Oct 14, 2026
- Last updated
- Oct 14, 2026
- Sex
- Male
- 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 | 91341 | CA | Primary |
Addresses
Primary practice location
16850 Bear Valley Rd
Victorville, CA 92395-5794
Mailing address
7265 Ashwood CT
Fontana, CA 92336-0899
Phone (626) 226-7013
Other practice location 1
18300 US Highway 18
Apple Valley, CA 92307-2206
Phone (760) 242-2311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791936000000",
"number": "1205732526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7265 ASHWOOD CT",
"city": "FONTANA",
"state": "CA",
"postal_code": "923360899",
"telephone_number": "626-226-7013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16850 BEAR VALLEY RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923955794",
"telephone_number": "760-241-8000"
}
],
"practiceLocations": [
{
"address_1": "18300 US Highway 18",
"address_purpose": "LOCATION",
"city": "Apple Valley",
"state": "CA",
"postal_code": "923072206",
"country_code": "US",
"telephone_number": "760-242-2311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA",
"first_name": "JAEVON",
"middle_name": "KAI",
"credential": "PHARMD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-14",
"last_updated": "2026-10-14",
"certification_date": "2026-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "91341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.