Individual provider Active NPI

Reece Jesus De Leon, RPH

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1245838952
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61889 Issued in CA
Practice address
1939 Monterey Hwy Ste 2
San Jose, CA 95112-6149
Phone
(408) 378-2363
NPI assigned
Oct 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61889 CA Primary

Addresses

Primary practice location

1939 Monterey Hwy Ste 2
San Jose, CA 95112-6149

Mailing address

1939 Monterey Hwy Ste 2
San Jose, CA 95112-6149
Phone (408) 378-2363

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
61889CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Botika Inc CurrentSince Oct 19, 2020 Accepting new patients

Locations

1939 Monterey Hwy
Ste 2
San Jose, CA 95112
Phone (408) 378-2363

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1245838952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MONTEREY HWY STE 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951126149",
            "telephone_number": "408-378-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 MONTEREY HWY STE 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951126149",
            "telephone_number": "408-378-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "REECE JESUS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.