Provider Demographics
NPI:1043505084
Name:SCZECH, JILL CHRISTINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:CHRISTINA
Last Name:SCZECH
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:PO BOX 3025
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729-3025
Mailing Address - Country:US
Mailing Address - Phone:714-235-7775
Mailing Address - Fax:
Practice Address - Street 1:19035 BEAR VALLEY RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-2712
Practice Address - Country:US
Practice Address - Phone:760-961-7325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist