Active NPI
Emilio Bethencourt, PHARM.D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Rocklin, CA
National Provider Identifier
1336399351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 45964
- Practice address
- 2246 Wild Plains Cir
Rocklin, CA 95765-5371 - Phone
- (916) 799-2477
- NPI assigned
- Sep 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 052377-1 | NY | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 45964 | CA | Primary |
Addresses
Primary practice location
2246 Wild Plains Cir
Rocklin, CA 95765-5371
Mailing address
2246 Wild Plains Cir
Rocklin, CA 95765-5371
Phone (916) 799-2477
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052377-1 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436140800000",
"number": "1336399351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2246 WILD PLAINS CIR",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957655371",
"telephone_number": "916-799-2477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2246 WILD PLAINS CIR",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957655371",
"telephone_number": "916-799-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETHENCOURT",
"first_name": "EMILIO",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-26",
"last_updated": "2015-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "052377-1",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "45964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocklin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.