Provider Demographics
NPI:1497056048
Name:FENOLIO, JAMES DAVIDSON (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DAVIDSON
Last Name:FENOLIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 TASSAJARA RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4501
Mailing Address - Country:US
Mailing Address - Phone:925-551-5600
Mailing Address - Fax:925-551-5605
Practice Address - Street 1:4440 TASSAJARA RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4501
Practice Address - Country:US
Practice Address - Phone:925-551-5600
Practice Address - Fax:925-551-5605
Is Sole Proprietor?:No
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26061183500000X
HI1261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist