Provider Demographics
NPI:1093447419
Name:VALDEZ-BEDIKIAN, JACQUELINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:VALDEZ-BEDIKIAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 ROSSMOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1853
Mailing Address - Country:US
Mailing Address - Phone:818-425-2585
Mailing Address - Fax:
Practice Address - Street 1:501 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2870
Practice Address - Country:US
Practice Address - Phone:818-242-5887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist