Provider Demographics
NPI:1215011432
Name:WORLEY, JEFFERY MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:MICHAEL
Last Name:WORLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:MICHAEL
Other - Last Name:WORLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7300 N FRESNO ST
Mailing Address - Street 2:MEDICINE 2, CLOVIS
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2941
Mailing Address - Country:US
Mailing Address - Phone:559-324-5071
Mailing Address - Fax:559-324-5571
Practice Address - Street 1:2071 HERNDON AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6101
Practice Address - Country:US
Practice Address - Phone:559-324-5071
Practice Address - Fax:559-324-5571
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 49263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH49263OtherPHARMACY LICENSE