Provider Demographics
NPI:1316457567
Name:GRASSMAN, JANET A (RPH)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:A
Last Name:GRASSMAN
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 1:1000 W MOFFETT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT JONES
Mailing Address - State:CA
Mailing Address - Zip Code:96032-9728
Mailing Address - Country:US
Mailing Address - Phone:530-468-5901
Mailing Address - Fax:
Practice Address - Street 1:1842 FORT JONES RD
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-9531
Practice Address - Country:US
Practice Address - Phone:530-842-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist