Individual provider Active NPI

Jessica Grace Manalang

  • Pharmacist
  • Stockton, CA
National Provider Identifier
1205796430
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
91595 Issued in CA
Practice address
5713 N Pershing Ave Ste A3
Stockton, CA 95207-4910
Phone
(209) 488-7770
NPI assigned
Nov 11, 2025
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 91595 CA Primary

Addresses

Primary practice location

5713 N Pershing Ave Ste A3
Stockton, CA 95207-4910

Mailing address

9804 Carico Way
Elk Grove, CA 95757-6389

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

LicenseStateTypeSpecialty
91595CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1205796430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9804 CARICO WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957576389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5713 N PERSHING AVE STE A3",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952074910",
            "telephone_number": "209-488-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALANG",
        "first_name": "JESSICA GRACE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-11-11",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "91595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.