Provider Demographics
NPI:1609543867
Name:JAGER, JANICE MARLA (PHARMD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:MARLA
Last Name:JAGER
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 1:5217 LENNOX AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5607
Mailing Address - Country:US
Mailing Address - Phone:818-915-2335
Mailing Address - Fax:
Practice Address - Street 1:5217 LENNOX AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5607
Practice Address - Country:US
Practice Address - Phone:818-915-2335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist