Provider Demographics
NPI:1437441771
Name:JENKINS, CHRISTINA MANCILLA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MANCILLA
Last Name:JENKINS
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 1:3955 BONITA RD
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-1230
Mailing Address - Country:US
Mailing Address - Phone:619-409-6408
Mailing Address - Fax:619-409-6410
Practice Address - Street 1:3955 BONITA RD
Practice Address - Street 2:
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902-1230
Practice Address - Country:US
Practice Address - Phone:619-409-6408
Practice Address - Fax:619-409-6410
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA611451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist