Provider Demographics
NPI:1134981699
Name:NAKHLA, JESSICA YEHIA (RPH)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:YEHIA
Last Name:NAKHLA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1652
Mailing Address - Country:US
Mailing Address - Phone:626-281-1637
Mailing Address - Fax:
Practice Address - Street 1:2551 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-1652
Practice Address - Country:US
Practice Address - Phone:626-281-1637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist