Crystal L Tettenhorst, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

87213 Issued in CA

Practice address

137 Harvard Ave
Claremont, CA 91711-4717

Phone

(909) 624-1611

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670025600000",
    "number": "1982299079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HARVARD AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114717",
            "telephone_number": "909-624-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 HARVARD AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114717",
            "telephone_number": "909-624-1611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15391 Rockwell Ave",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923364107",
            "country_code": "US",
            "telephone_number": "619-804-0659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETTENHORST",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2022-12-03",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2022; 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.