Provider Demographics
NPI:1093461634
Name:SHATSWELL, JANAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANAE
Middle Name:
Last Name:SHATSWELL
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 1:361 E LELAND RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4911
Mailing Address - Country:US
Mailing Address - Phone:925-432-9770
Mailing Address - Fax:925-432-9774
Practice Address - Street 1:361 E LELAND RD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4911
Practice Address - Country:US
Practice Address - Phone:925-432-9770
Practice Address - Fax:925-432-9774
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH84967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist