Provider Demographics
NPI:1588976146
Name:CHRISTMAN-DEGRUY, JANET (RPH)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CHRISTMAN-DEGRUY
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 1:39454 BEACON LN
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1095
Mailing Address - Country:US
Mailing Address - Phone:805-639-3737
Mailing Address - Fax:
Practice Address - Street 1:3105 RANCHO VISTA BLVD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4822
Practice Address - Country:US
Practice Address - Phone:661-538-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-11
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist