Jessa Marie Koch, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

75756 Issued in CA

Practice address

250 S G St
San Bernardino, CA 92410-3320

Phone

(855) 558-1100

NPI assigned

Jun 18, 2014

Last updated

Mar 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jkoch119221@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1508270463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "855-558-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "855-558-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "JESSA",
        "middle_name": "MARIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP448743",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "75756",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "PA",
            "license": "RP448743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi D Knipe Laird, PHD
• Knotts Family & Parenting Institute
• Knotts Family Agency
• Knotts Group Home
• Gwendolyn K Knotts
• Christian Koeu
• Kohut Psychiatric Medical Group Inc
• Koinonia Foster Homes, Inc. (Koinonia Family Services)
• Nikhitha Konda, M.D.
• Kooley Transportation

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.