# DR. JARRED B PRUDENCIO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649721994
- **Gender:** Man
- **Credential:** PHARM.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | PH-4021 | HI | Yes |
| 1835P2201X | Ambulatory Care Pharmacist | PH-4021 | HI | — |

## Other

- **Enumeration date:** 10/21/2016
- **Last updated:** 10/21/2016