Provider Demographics
NPI:1346613858
Name:CASSEL, JILLIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:CASSEL
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 1:1039 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1690
Mailing Address - Country:US
Mailing Address - Phone:650-780-9910
Mailing Address - Fax:650-780-9913
Practice Address - Street 1:1039 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1690
Practice Address - Country:US
Practice Address - Phone:650-780-9910
Practice Address - Fax:650-780-9913
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist