Provider Demographics
NPI:1720428741
Name:TEIJELO, ASHLEY S (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
Last Name:TEIJELO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 PUTTY HILL AVE
Mailing Address - Street 2:T-1142
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5844
Mailing Address - Country:US
Mailing Address - Phone:410-823-4543
Mailing Address - Fax:
Practice Address - Street 1:2420 FENTON ST STE 100
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3516
Practice Address - Country:US
Practice Address - Phone:619-498-6499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist