Onesource Compounding Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY 55294 Issued in CA

Legal business name

ONESOURCE COMPOUNDING PHARMACY

Practice address

104 Whispering Pines Dr Ste 105
Scotts Valley, CA 95066

Phone

(831) 535-6864

NPI assigned

May 17, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Sesylia Astor, RPH

Title

Pharmacist

Phone

(831) 345-6404

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1770010068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WHISPERING PINES DR STE 105",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664799",
            "telephone_number": "831-535-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WHISPERING PINES DR STE 105",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "95066",
            "telephone_number": "831-535-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONESOURCE COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "ASTOR",
        "authorized_official_first_name": "SESYLIA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "831-345-6404",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY 55294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nomi
• Alexa Noriega
• Maya Nunes
• Ariana Rice Oday, LMFT
• Aaron Olivares
• Quirino Ortiz Jr.
• Kelly Otis, RPT
• Mona Oyos
• Kimberly Pacis, PHARM.D.
• Alicia Paris-Pombo, M.D.

• Compounding Pharmacy in Scotts Valley, CA
• Providers in Scotts Valley, CA by specialty
• Compounding Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.