Individual provider Active NPI

Mariclaire Gladys Tajonera, PHARMD

  • Pharmacist
  • Ladera Ranch, CA
National Provider Identifier
1679948020
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
44487 Issued in CA
Practice address
27702 Crown Valley Pkwy
Suite I
Ladera Ranch, CA 92694-0608
Phone
(949) 364-1430
Fax
(949) 364-1734
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 44487 CA Primary

Addresses

Primary practice location

27702 Crown Valley Pkwy
Suite I
Ladera Ranch, CA 92694-0608

Mailing address

27702 Crown Valley Pkwy
Suite I
Ladera Ranch, CA 92694-0608
Phone (949) 364-1430

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

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1679948020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 CROWN VALLEY PKWY",
            "address_2": "SUITE I",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940608",
            "telephone_number": "949-364-1430",
            "fax_number": "949-364-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27702 CROWN VALLEY PKWY",
            "address_2": "SUITE I",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940608",
            "telephone_number": "949-364-1430",
            "fax_number": "949-364-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJONERA",
        "first_name": "MARICLAIRE",
        "middle_name": "GLADYS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "44487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.