Active NPI
Jamie Carmela Raymundo De Vera, PHARMD
- Pharmacist
- Hesperia, CA
National Provider Identifier
1679333637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 89292
- Practice address
- 16975 Bear Valley Rd
Hesperia, CA 92345-1809 - Phone
- (760) 947-7043
- NPI assigned
- Mar 19, 2024
- Last updated
- Apr 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 89292 | CA | Primary |
Addresses
Primary practice location
16975 Bear Valley Rd
Hesperia, CA 92345-1809
Mailing address
17880 Paseo Lunada
Apple Valley, CA 92307-1295
Phone (626) 710-6890
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
| License | State | Type | Specialty |
|---|---|---|---|
| 89292 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714176000000",
"number": "1679333637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17880 PASEO LUNADA",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923071295",
"telephone_number": "626-710-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16975 BEAR VALLEY RD",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923451809",
"telephone_number": "760-947-7043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE VERA",
"first_name": "JAMIE CARMELA",
"middle_name": "RAYMUNDO",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-19",
"last_updated": "2024-04-27",
"certification_date": "2024-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "89292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.