Provider Demographics
NPI:1043591993
Name:CHERIAN, JEMY MERIN
Entity Type:Individual
Prefix:MRS
First Name:JEMY
Middle Name:MERIN
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6281 JOAQUIN MURIETA AVE
Mailing Address - Street 2:UNIT F
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-8524
Mailing Address - Country:US
Mailing Address - Phone:510-249-9632
Mailing Address - Fax:
Practice Address - Street 1:5055 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2040
Practice Address - Country:US
Practice Address - Phone:510-595-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist