Active NPI
Jennifer Pak, PHARM.D
- Pharmacist
- Loma Linda, CA
National Provider Identifier
1932502655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71629
- Practice address
- 25587 Prospect Ave
Loma Linda, CA 92354-3167 - Phone
- (909) 263-5523
- NPI assigned
- Oct 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 71629 | CA | Primary |
Addresses
Primary practice location
25587 Prospect Ave
Loma Linda, CA 92354-3167
Mailing address
25587 Prospect Ave
Loma Linda, CA 92354-3167
Phone (909) 263-5523
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
| License | State | Type | Specialty |
|---|---|---|---|
| 71629 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412726400000",
"number": "1932502655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25587 PROSPECT AVE",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543167",
"telephone_number": "909-263-5523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25587 PROSPECT AVE",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543167",
"telephone_number": "909-263-5523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAK",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-08",
"last_updated": "2014-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "71629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.