Provider Demographics
NPI:1528199577
Name:SOHN, JEANNIE M (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:M
Last Name:SOHN
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 1:6573 MOUNT ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-1937
Mailing Address - Country:US
Mailing Address - Phone:650-299-2706
Mailing Address - Fax:650-299-3821
Practice Address - Street 1:6573 MOUNT ROYAL DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-1937
Practice Address - Country:US
Practice Address - Phone:650-299-2706
Practice Address - Fax:650-299-3821
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA368371835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA958953OtherNUID