Provider Demographics
NPI:1215221163
Name:KING, JENNIFER D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:D
Last Name:KING
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 1:560 CONTRA COSTA BLVD
Mailing Address - Street 2:T-0330
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1216
Mailing Address - Country:US
Mailing Address - Phone:925-685-5244
Mailing Address - Fax:925-685-5244
Practice Address - Street 1:560 CONTRA COSTA BLVD
Practice Address - Street 2:T-0330
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1216
Practice Address - Country:US
Practice Address - Phone:925-685-5244
Practice Address - Fax:925-685-5244
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist