Provider Demographics
NPI:1942536479
Name:HALILOVIC, JENANA (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:JENANA
Middle Name:
Last Name:HALILOVIC
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 I ST
Mailing Address - Street 2:#B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4259
Mailing Address - Country:US
Mailing Address - Phone:401-829-2825
Mailing Address - Fax:
Practice Address - Street 1:2505 I ST
Practice Address - Street 2:#B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4259
Practice Address - Country:US
Practice Address - Phone:401-829-2825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-18
Last Update Date:2009-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605771835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist