Jacquelyn Rose Cituk, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

86446 Issued in CA

Practice address

900 Greenley Rd
Suite 908
Sonora, CA 95370-5287

Phone

(209) 536-3699

Fax

(209) 536-3584

NPI assigned

Aug 27, 2013

Last updated

Aug 27, 2013By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1881028843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 GREENLEY RD",
            "address_2": "SUITE 908",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705287",
            "telephone_number": "209-536-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 GREENLEY RD",
            "address_2": "SUITE 908",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705287",
            "telephone_number": "209-536-3699",
            "fax_number": "209-536-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITUK",
        "first_name": "JACQUELYN",
        "middle_name": "ROSE",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "86446",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.289722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Sonora, CA
• Providers in Sonora, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.