Individual provider Active NPI

Jenifer Leuck, PHARM D

  • Pharmacist
  • San Ysidro, CA
National Provider Identifier
1649979717
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
43768 Issued in CA
Practice address
1660 Precision Park LN
San Ysidro, CA 92173-1346
Phone
(619) 994-3743
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 43768 CA Primary

Addresses

Primary practice location

1660 Precision Park LN
San Ysidro, CA 92173-1346

Mailing address

1220 Rosecrans Street PMB 209
San Diego, CA 92106

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
43768CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1649979717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 ROSECRANS STREET PMB 209",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 PRECISION PARK LN",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731346",
            "telephone_number": "619-994-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUCK",
        "first_name": "JENIFER",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "43768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ysidro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.