Rebecca Ann Jimenez
Individual provider Active NPI Pharmacist · Madera, CA
NPI 1508555715 · NPPES record last updated May 3, 2023
Key facts
- NPI
- 1508555715
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 87896 (CA)
- Practice address
- 1109 Country Club Dr
Madera, CA 93638-1598 - Phone
- (559) 673-0003
- NPI assigned
- May 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past |
Accepting new patients | |
| Longs Drug Store California LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 87896 | CA | Yes |
Addresses
Primary practice location
1109 Country Club Dr
Madera, CA 93638-1598
Mailing address
1717 E Bullard Ave Apt 115
Fresno, CA 93710-5831
Phone (559) 286-5325
Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.