Provider Demographics
NPI:1992172472
Name:SEWALL, JARED ANDREW (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:ANDREW
Last Name:SEWALL
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 UNIVERSITY AVE
Mailing Address - Street 2:UNIT 506
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1786
Mailing Address - Country:US
Mailing Address - Phone:774-283-2007
Mailing Address - Fax:
Practice Address - Street 1:1411 E. 31ST ST
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1018
Practice Address - Country:US
Practice Address - Phone:510-437-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73123183500000X
CAINT33678390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program