Provider Demographics
NPI:1659659050
Name:ANDERSON, JENNIFER ALISON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ALISON
Last Name:ANDERSON
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 1:1366 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7336
Mailing Address - Country:US
Mailing Address - Phone:530-899-2322
Mailing Address - Fax:530-899-2325
Practice Address - Street 1:1366 EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7336
Practice Address - Country:US
Practice Address - Phone:530-899-2322
Practice Address - Fax:530-899-2325
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist