Chettra So Prum

Primary specialty

PharmacistTaxonomy code 183500000X

License

77373 Issued in CA

Practice address

6477 Almaden Expy
San Jose, CA 95120-2902

Phone

(408) 550-5547

NPI assigned

Sep 26, 2017

Last updated

Sep 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1790294395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6477 ALMADEN EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6477 ALMADEN EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202902",
            "telephone_number": "408-550-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUM",
        "first_name": "CHETTRA",
        "middle_name": "SO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tania Protsenko, MA IN COUNSELING PSY
• Beth Turner Proudfoot, LMFT
• Natalie Kristine Provenzano, D.D.S.
• Janelle Provost, DC
• Alysha Prum
• Phyllis Lynn Pryor
• Psychelogik Psychological, Inc.
• PT2 Physical & Sports Therapy Inc. (PT2 Physical & Sports Therapy with a Personal Touch)
• Nestor Puente
• Rosario Puga-Dempsey

• Pharmacist in San Jose, CA
• Providers in San Jose, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; 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.