Active NPI
Adrienne Jeong Hatae
- Ambulatory Care Pharmacist
- Fullerton, CA
National Provider Identifier
1851083414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 59772
- Practice address
- 401 Fiesta PL
Fullerton, CA 92835-3407 - Phone
- (626) 235-5611
- NPI assigned
- May 23, 2023
- Last updated
- May 23, 2023
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 59772 | CA | Primary |
Addresses
Primary practice location
401 Fiesta PL
Fullerton, CA 92835-3407
Mailing address
401 Fiesta PL
Fullerton, CA 92835-3407
Phone (626) 235-5611
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59772 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1851083414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 FIESTA PL",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353407",
"telephone_number": "626-235-5611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 FIESTA PL",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353407",
"telephone_number": "626-235-5611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATAE",
"first_name": "ADRIENNE",
"middle_name": "JEONG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "CA",
"license": "59772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.