Provider Demographics
NPI:1932649597
Name:JARRETT-JAMISON, JOELLEN (PHARMD)
Entity type:Individual
Prefix:
First Name:JOELLEN
Middle Name:
Last Name:JARRETT-JAMISON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 N HIGHLAND SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-3048
Mailing Address - Country:US
Mailing Address - Phone:951-845-5984
Mailing Address - Fax:951-845-7845
Practice Address - Street 1:60 N HIGHLAND SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-3048
Practice Address - Country:US
Practice Address - Phone:951-845-5984
Practice Address - Fax:951-845-7845
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist