SASIPAN JETAWATANA


Address: 18350 Roscoe Blvd, Northridge, CA 91325-4109
Phone: 8186885772

SASIPAN JETAWATANA (NPI# 1053763144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053763144
Entity Type Individual
Full Name SASIPAN JETAWATANA
Practice Address 18350 Roscoe Blvd
Northridge
CA 91325-4109
Mailing Address 21901 Lassen St Unit 103
Chatsworth
CA 91311-3651
Practice Telephone 8186885772
Enumeration Date 2016-07-12
Last Update Date 2017-05-12
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 183500000X Pharmacist 73148 CA Pharmacy Service Providers

Office Location

Street Address 18350 ROSCOE BLVD
City NORTHRIDGE
State CA
Zip Code 91325-4109

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003808494 Andrew Chang Ophthalmology 18350 Roscoe Blvd, Suite 101, Northridge, CA 91325-4109 2005-08-22
1386145324 Farhad Fred Naziri Pharmacist 18350 Roscoe Blvd, 102, Northridge, CA 91325-4146 2018-02-26
1972956852 Tobi Quinto Pathology 18350 Roscoe Blvd, Northridge, CA 91325-4109 2016-07-15
1427457738 Md Breath Testing Laboratory Clinical Medical Laboratory 18350 Roscoe Blvd, Suite 303, Northridge, CA 91325-4109 2014-08-22
1588003487 Jennifer Gabrielle Bronson Nurse Practitioner 18350 Roscoe Blvd, 213, Northridge, CA 91325-4109 2013-06-24
1972857464 Marc Kerner, M.d., A.p.c. Specialist 18350 Roscoe Blvd, Suite 318, Northridge, CA 91325-4109 2012-11-05
1992072474 Ronald Accomazzo, Md, A Medical Corporation Specialist 18350 Roscoe Blvd, Suite 318, Northridge, CA 91325-4109 2011-11-28
1841441706 Mandana Barahimi General Acute Care Hospital 18350 Roscoe Blvd, Suite 600, Northridge, CA 91325-4187 2008-10-08
1093966236 Ritoo Gagneja Family Medicine 18350 Roscoe Blvd, Suite 600, Northridge, CA 91325-4109 2008-10-07
1275703969 Bjorn Mark Lobo Neurological Surgery 18350 Roscoe Blvd, Suite 405, Northridge, CA 91325-4109 2008-03-10
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396346961 Patricia Yamilet Morales Registered Nurse 18300 Roscoe Blvd Dignity Health- Northridge Hospital M, Northridge, CA 91325 2020-11-02
1790342897 Northridge Kidney Center, LLC Clinic/Center 17710 Roscoe Blvd, Northridge, CA 91325 2019-05-23
1063078376 Ozlem Alper Student in an Organized Health Care Education/Training Program 18497 Dearborn St, Unit 112, Northridge, CA 91325 2019-05-13
1144883489 Better Sober Clinic/Center 9339 Louse Ave, Northridge, CA 91325 2019-04-22
1902383920 Ntr Resources, LLC Pathology 17433 Nordhoff, Northridge, CA 91325 2018-07-23
1043713969 Poly-med Pharmacy Inc Pharmacy 17313 Roscoe Blvd, Northridge, CA 91325 2018-03-16
1982151940 Maria Dakessian Dentist 18250 Roscoe Blvd Ste 345, Northridge, CA 91325 2016-09-07
1487019469 Beshoy Gerges Pharmacist 8254 White Oak Ave Unit 4, Northridge, CA 91325 2015-12-17
1235520305 Gema Bautista Social Worker 8550 Balboa Blvd Ste 216, Northridge, CA 91325 2015-02-11
1083018873 Sosann Haider Pharmacist 18444 Plummer St., Northridge, CA 91325 2014-10-22
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Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679180350 Robert Chad Hakim Pharmacist 9415 White Oak Ave, Northridge, CA 91325-2337 2020-09-28
1700411055 Ike Dahjet Pharmacist 18546 Roscoe Blvd Ste 102, Northridge, CA 91324-4667 2020-03-06
1629603055 Gulamdastageer Allie Pharmacist 19331 Business Center Dr Ste 100, Northridge, CA 91324-3533 2020-03-05
1427610070 Kathryn Stephanie Blanco Adriatico Pharmacist 16647 Labrador St, Northridge, CA 91343-1717 2019-07-03
1114488293 Erish Malonzo Pharmacist 8302 Rathburn Ave, Northridge, CA 91325-4208 2019-03-29
1407312523 Tanya Rita Kalandjian Pharmacist 18342 Malden St Unit 6, Northridge, CA 91325-3668 2019-02-13
1164933206 Jennifer Vi-van To Pharmacist 20345 Via Urbino, Northridge, CA 91326-4445 2017-10-17
1861930596 Arlene Balian Pharmacist 8415 Reseda Blvd, Suite 6, Northridge, CA 91324-4642 2017-02-01
1487019469 Beshoy Gerges Pharmacist 8254 White Oak Ave Unit 4, Northridge, CA 91325 2015-12-17
1154794899 Shirlin Baharian Pharmacist 17151 Stare St, Northridge, CA 91325-1666 2015-11-03
Find all providers in NORTHRIDGE

Competitor

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City NORTHRIDGE
Zip Code 91325

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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