Provider Demographics
NPI:1649369794
Name:RICH, JEAN ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ANN
Last Name:RICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:ANN
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4501 RAMONA DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1182
Mailing Address - Country:US
Mailing Address - Phone:951-353-4498
Mailing Address - Fax:951-353-4076
Practice Address - Street 1:10800 MAGNOLIA AVENUE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505
Practice Address - Country:US
Practice Address - Phone:951-353-4498
Practice Address - Fax:951-353-4076
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH42045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist