Active NPI
Jane Marie Kreis, RPH, MBA
- Pharmacist
- Fairfield, CA
National Provider Identifier
1780897355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17329
- Practice address
- Travis Afb
101 Bodin Circle
Fairfield, CA 94535 - Phone
- (707) 423-7121
- NPI assigned
- May 8, 2007
- 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 | 17329 | OH | Primary |
Addresses
Primary practice location
Travis Afb
101 Bodin Circle
Fairfield, CA 94535
Mailing address
724 Roscommon Drive
Vacaville, CA 95688
Phone (707) 448-1225
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
- Master of Business Administration, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17329 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780897355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "724 ROSCOMMON DRIVE",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95688",
"telephone_number": "707-448-1225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TRAVIS AFB",
"address_2": "101 BODIN CIRCLE",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94535",
"telephone_number": "707-423-7121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREIS",
"first_name": "JANE",
"middle_name": "MARIE",
"credential": "RPH, MBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "17329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.