Basic Information
Provider Information | |||||||||
NPI: | 1467596973 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HUTSELL | ||||||||
FirstName: | JONELL | ||||||||
MiddleName: | JANEEN | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | PHARM. D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2040 WISCONSIN AVE | ||||||||
Address2: |   | ||||||||
City: | REDDING | ||||||||
State: | CA | ||||||||
PostalCode: | 960012907 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5302443859 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2480 SONOMA ST | ||||||||
Address2: |   | ||||||||
City: | REDDING | ||||||||
State: | CA | ||||||||
PostalCode: | 960013027 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5302257800 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/16/2007 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 57883 | CA | X |   | Pharmacy Service Providers | Pharmacist |   | 1835G0303X | 57883 | CA | X |   | Pharmacy Service Providers | Pharmacist | Geriatric | 1835N1003X | 57883 | CA | X |   | Pharmacy Service Providers | Pharmacist | Nutrition Support | 1835P1200X | 57883 | CA | X |   | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 1835X0200X | 57883 | CA | X |   | Pharmacy Service Providers | Pharmacist | Oncology |
No ID Information.