Provider Demographics
NPI:1124687587
Name:CHEN, JANINE N (RPH)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:N
Last Name:CHEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-2942
Mailing Address - Country:US
Mailing Address - Phone:909-596-6168
Mailing Address - Fax:909-596-6155
Practice Address - Street 1:2143 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-2942
Practice Address - Country:US
Practice Address - Phone:909-596-6168
Practice Address - Fax:909-596-6155
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist