Individual provider Active NPI

Jenny Park Guarin, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1508273459
Registry record updated Jun 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
70636 Issued in CA
Practice address
9455 Clairemont Mesa Blvd
San Diego, CA 92123-1297
Phone
(844) 328-9077
Fax
(858) 266-2585
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 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 70636 CA Primary

Addresses

Primary practice location

9455 Clairemont Mesa Blvd
San Diego, CA 92123-1297

Mailing address

2518 La Costa Ave
Chula Vista, CA 91915-1408
Phone (858) 531-2055

Other practice location 1

659 E Palomar St
Chula Vista, CA 91911-6974
Phone (619) 397-0466

Other identifiers 1

IdentifierTypeStateIssuer
70636OtherCACALIFORNIA BOARD OF PHARMACY LICENSE

Other names 1

  • Jenny Park Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ralphs Grocery Company Past Accepting new patients
Ralphs Grocery Company Past Accepting new patients

Organizations & group practices 2

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": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591401600000",
    "number": "1508273459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 LA COSTA AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151408",
            "telephone_number": "858-531-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9455 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231297",
            "telephone_number": "844-328-9077",
            "fax_number": "858-266-2585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "659 E Palomar St",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919116974",
            "country_code": "US",
            "telephone_number": "619-397-0466",
            "fax_number": "619-397-0926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUARIN",
        "first_name": "JENNY",
        "middle_name": "PARK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2020-06-06",
        "certification_date": "2020-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF PHARMACY LICENSE",
            "identifier": "70636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "PARK",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.