Provider Demographics
NPI:1669143723
Name:CARIAGA, JANESSA ESMERIA
Entity type:Individual
Prefix:DR
First Name:JANESSA
Middle Name:ESMERIA
Last Name:CARIAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731139
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95173-1139
Mailing Address - Country:US
Mailing Address - Phone:408-712-8646
Mailing Address - Fax:
Practice Address - Street 1:1550 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-4539
Practice Address - Country:US
Practice Address - Phone:408-264-8642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist