Individual provider Active NPI

Jennifer Lew

  • Pharmacist
  • Montclair, CA
National Provider Identifier
1447546445
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
53761 Issued in CA
Practice address
9052 Central Ave
Store #1423
Montclair, CA 91763-1621
Phone
(909) 447-6785
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 53761 CA Primary

Addresses

Primary practice location

9052 Central Ave
Store #1423
Montclair, CA 91763-1621

Mailing address

9052 Central Ave
Store #1423
Montclair, CA 91763-1621

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
53761CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina CVS Pharmacy LLC Past Accepting new patients

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1447546445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9052 CENTRAL AVE",
            "address_2": "STORE #1423",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9052 CENTRAL AVE",
            "address_2": "STORE #1423",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631621",
            "telephone_number": "909-447-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEW",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "53761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.