Individual provider Active NPI

Victoria Lauren Tolentino, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bullhead City, AZ
National Provider Identifier
1962032896
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
S024435 Issued in AZ
Practice address
1775 Lakeside Dr
Bullhead City, AZ 86442-5732
Phone
(928) 763-8777
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 8759128-1701 UT
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 19715 NV
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X S024435 AZ Primary

Addresses

Primary practice location

1775 Lakeside Dr
Bullhead City, AZ 86442-5732

Mailing address

1775 Lakeside Dr
Bullhead City, AZ 86442-5732
Phone (928) 763-8777

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

LicenseStateTypeSpecialty
S024435AZMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
8759128-1701UTMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc PastSince Jan 26, 2020 Accepting new patients
Smith'S Food & Drug Centers Inc PastSince Jan 26, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1962032896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 LAKESIDE DR",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864425732",
            "telephone_number": "928-763-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 LAKESIDE DR",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864425732",
            "telephone_number": "928-763-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "VICTORIA",
        "middle_name": "LAUREN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "UT",
            "license": "8759128-1701",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NV",
            "license": "19715",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AZ",
            "license": "S024435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.