Individual provider Active NPI

Jackelyn Hong, PHARM.D.

  • Pharmacist
  • San Bernardino, CA
National Provider Identifier
1588065700
Registry record updated Sep 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69465 Issued in CA
Practice address
4001 Hallmark Pkwy
San Bernardino, CA 92407-1876
Phone
(909) 880-3652
NPI assigned
Sep 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69465 CA Primary

Addresses

Primary practice location

4001 Hallmark Pkwy
San Bernardino, CA 92407-1876

Mailing address

4001 Hallmark Pkwy
San Bernardino, CA 92407-1876
Phone (909) 880-3652

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

LicenseStateTypeSpecialty
69465CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1410048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410048000000",
    "number": "1588065700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 HALLMARK PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924071876",
            "telephone_number": "909-880-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 HALLMARK PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924071876",
            "telephone_number": "909-880-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "JACKELYN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-07",
        "last_updated": "2014-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "69465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2014; 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.