Provider Demographics
NPI:1013399021
Name:ALVAREZ, JASON JEFFREY
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:JEFFREY
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N DEMAREE ST
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-7714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1320 N DEMAREE ST
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-7714
Practice Address - Country:US
Practice Address - Phone:559-429-3267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist