Individual provider Active NPI

Jennifer E Matias, PHARM.D.

  • Pharmacist
  • Downey, CA
National Provider Identifier
1962539320
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
56498 Issued in CA
Practice address
12254 Bellflower Blvd
Downey, CA 90242
Phone
(562) 658-3192
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 56498 CA Primary

Addresses

Primary practice location

12254 Bellflower Blvd
Downey, CA 90242

Mailing address

12254 Bellflower Blvd
Downey, CA 90242-2804
Phone (562) 658-3192

Other practice location 1

17100 Euclid St
Pharmacy Department
Fountain Valley, CA 92708-4004
Phone (714) 966-8115 ext. 1

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
56498CAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1962539320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422804",
            "telephone_number": "562-658-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12254 BELLFLOWER BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-658-3192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17100 Euclid St",
            "address_2": "Pharmacy Department",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927084004",
            "country_code": "US",
            "telephone_number": "714-966-8115 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATIAS",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "56498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.