Provider Demographics
NPI:1972740736
Name:AVERILL, JOANN SUSAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOANN
Middle Name:SUSAN
Last Name:AVERILL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23388 MULHOLLAND DR
Mailing Address - Street 2:PHARMACY DEPT
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2733
Mailing Address - Country:US
Mailing Address - Phone:818-876-4040
Mailing Address - Fax:818-876-1398
Practice Address - Street 1:23388 MULHOLLAND DR
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2733
Practice Address - Country:US
Practice Address - Phone:818-876-4040
Practice Address - Fax:818-876-1398
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH484541835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist