Individual provider Active NPI

Jenna Kristine Markus, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1790404218
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
86020 Issued in CA
Practice address
2555 Chalcedony St
San Diego, CA 92109-2333
Phone
(916) 591-9340
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P9709 ID
Pharmacist 183500000X 86020 CA Primary

Addresses

Primary practice location

2555 Chalcedony St
San Diego, CA 92109-2333

Mailing address

2555 Chalcedony St
San Diego, CA 92109-2333
Phone (916) 591-9340

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

LicenseStateTypeSpecialty
86020CAMDPharmacist
P9709IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1790404218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 CHALCEDONY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092333",
            "telephone_number": "916-591-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 CHALCEDONY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092333",
            "telephone_number": "916-591-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKUS",
        "first_name": "JENNA",
        "middle_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P9709",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "86020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.