Provider Demographics
NPI:1700904729
Name:JAIME, VERONICA MARTIN (PHARMACY TECH)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:MARTIN
Last Name:JAIME
Suffix:
Gender:F
Credentials:PHARMACY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 EAST THIRD ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879
Mailing Address - Country:US
Mailing Address - Phone:951-735-4600
Mailing Address - Fax:951-284-4701
Practice Address - Street 1:221 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1438
Practice Address - Country:US
Practice Address - Phone:951-735-4600
Practice Address - Fax:951-284-4701
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14821183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician