Individual
JESSA MARIE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(855) 558-1100
Mailing address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(855) 558-1100
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP448743
PA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
75756
CA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RP448743
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2014
Last updated
03/16/2017
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