Provider Demographics
NPI:1639500713
Name:OKAFOR, JODY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JODY
Middle Name:
Last Name:OKAFOR
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 1:655 ENTERPRISE DR APT 103
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2471
Mailing Address - Country:US
Mailing Address - Phone:508-345-0080
Mailing Address - Fax:
Practice Address - Street 1:475 ROHNERT PARK EXPY W
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-7907
Practice Address - Country:US
Practice Address - Phone:707-585-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist