Provider Demographics
NPI:1982874020
Name:AQUINO, JANICE ANNE (CPHT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ANNE
Last Name:AQUINO
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:JANICE ANNE
Other - Middle Name:REYES
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2175 CAMINITO LEONZIO UNIT 28
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-4173
Mailing Address - Country:US
Mailing Address - Phone:619-623-3354
Mailing Address - Fax:
Practice Address - Street 1:2175 CAMINITO LEONZIO UNIT 28
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-4173
Practice Address - Country:US
Practice Address - Phone:619-623-3354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42152183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician