Active NPI
Brenna Duffy
- Pharmacist
- San Jacinto, CA
National Provider Identifier
1669961967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 75867
- Practice address
- 1861 S San Jacinto Ave
San Jacinto, CA 92583-5605 - Phone
- (951) 487-8409
- NPI assigned
- May 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 75867 | CA | Primary |
Addresses
Primary practice location
1861 S San Jacinto Ave
San Jacinto, CA 92583-5605
Mailing address
44972 Dolce St
Temecula, CA 92592-5530
Phone (951) 966-0241
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75867 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525219200000",
"number": "1669961967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44972 DOLCE ST",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925925530",
"telephone_number": "951-966-0241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1861 S SAN JACINTO AVE",
"city": "SAN JACINTO",
"state": "CA",
"postal_code": "925835605",
"telephone_number": "951-487-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFFY",
"first_name": "BRENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-02",
"last_updated": "2018-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "75867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jacinto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.