Individual provider Active NPI

Jean Marie Swanson, R.PH.

  • Pharmacist
  • Santa Rosa, CA
National Provider Identifier
1831469014
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36017 Issued in CA
Practice address
1980 Santa Rosa Ave
Santa Rosa, CA 95407-7621
Phone
(707) 575-0982
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36017 CA Primary

Addresses

Primary practice location

1980 Santa Rosa Ave
Santa Rosa, CA 95407-7621

Mailing address

1980 Santa Rosa Ave
Santa Rosa, CA 95407-7621
Phone (707) 575-0982

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
36017CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1831469014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 SANTA ROSA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077621",
            "telephone_number": "707-575-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 SANTA ROSA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077621",
            "telephone_number": "707-575-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "36017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.