Active NPI
Theresa Cherisse Taylor, PHARMD
- Pharmacist
- San Bernardino, CA
National Provider Identifier
1861937138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68363
- Practice address
- 618 S Mount Vernon Ave
Suite 136
San Bernardino, CA 92410-2762 - Phone
- (909) 888-9411
- Fax
- (909) 888-9088
- NPI assigned
- Dec 22, 2016
- Last updated
- Dec 22, 2016
- 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 | 68363 | CA | Primary |
Addresses
Primary practice location
618 S Mount Vernon Ave
Suite 136
San Bernardino, CA 92410-2762
Mailing address
1098 Medical Center Dr
San Bernardino, CA 92411-2024
Phone (909) 888-9411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH68363 | Other | CA | CALIFORNIA STATE BOARD OF PHARMACY |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agm RX Inc | Past | Accepting new patients | |
| Agm RX Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482364800000",
"number": "1861937138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1098 MEDICAL CENTER DR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924112024",
"telephone_number": "909-888-9411",
"fax_number": "909-888-9088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 S MOUNT VERNON AVE",
"address_2": "SUITE 136",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924102762",
"telephone_number": "909-888-9411",
"fax_number": "909-888-9088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "THERESA",
"middle_name": "CHERISSE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-22",
"last_updated": "2016-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68363",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA STATE BOARD OF PHARMACY",
"identifier": "RPH68363",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.