Provider Demographics
NPI:1033279740
Name:CHAVEZ, JENNIFER A (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 BAKER ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3840
Mailing Address - Country:US
Mailing Address - Phone:415-205-7413
Mailing Address - Fax:
Practice Address - Street 1:4131 GEARY BLVD RM B07
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3101
Practice Address - Country:US
Practice Address - Phone:415-833-4577
Practice Address - Fax:415-833-3106
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist