Provider Demographics
NPI:1780213140
Name:EDEN, JAIME (CPHT)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:EDEN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 OLD OAK CT
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-2715
Mailing Address - Country:US
Mailing Address - Phone:925-216-9442
Mailing Address - Fax:
Practice Address - Street 1:106 OLD OAK CT
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-2715
Practice Address - Country:US
Practice Address - Phone:925-216-9442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician