Provider Demographics
NPI:1730571811
Name:JENSEN, VALEREE (PHARMD)
Entity type:Individual
Prefix:
First Name:VALEREE
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:VALEREE
Other - Middle Name:
Other - Last Name:BOSTWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:676 N 12TH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-1430
Mailing Address - Country:US
Mailing Address - Phone:208-406-2190
Mailing Address - Fax:
Practice Address - Street 1:676 N 12TH ST APT 8
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-1430
Practice Address - Country:US
Practice Address - Phone:208-406-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist