Provider Demographics
NPI:1780126441
Name:GITHINJI, JACKLINE (PHARMD)
Entity type:Individual
Prefix:
First Name:JACKLINE
Middle Name:
Last Name:GITHINJI
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 1:9932 LINCOLN VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2908
Mailing Address - Country:US
Mailing Address - Phone:916-832-3056
Mailing Address - Fax:
Practice Address - Street 1:9932 LINCOLN VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2908
Practice Address - Country:US
Practice Address - Phone:916-832-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-12
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist