DR. KRISSA JEAN KLOTZLE (NPI# 1497080188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497080188 |
| Entity Type | Individual |
| Full Name | DR. KRISSA JEAN KLOTZLE |
| Credential | PHARMD, BCPS |
| Practice Address |
1855 N Fair Oaks Ave Pasadena CA 91103-1620 |
| Mailing Address |
401 Phalen Blvd Saint Paul MN 55130-5302 |
| Practice Telephone | 6263986300 |
| Mailing Telephone | 6512902731 |
| Mailing Fax Number | 6512547623 |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2019-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
74709 | CA | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
19999 | IA | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
118060-2 | MN | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3160 E Del Mar Blvd Ste 100, Pasadena, CA 911074649 | 6263986300 |
| Street Address |
1855 N FAIR OAKS AVE |
| City | PASADENA |
| State | CA |
| Zip Code | 91103-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154300630 | Taska K Moore | Obstetrics & Gynecology | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2006-01-12 |
| 1164997144 | Trindiad Flores | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-10-05 |
| 1467945287 | Lisa Michelle Cherqaoui | Registered Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-06-07 |
| 1124520267 | Ma. Cecilia Alonzo Verceles | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-03-05 |
| 1134621329 | Veronica Kay Helmuth | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-03-02 |
| 1740781723 | Jacqueline Flores | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-02-23 |
| 1144735895 | Angie Byung Ju Kim | Physician Assistant | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-12-04 |
| 1790299675 | Graciela Quevedo | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-30 |
| 1417461526 | Merci Taylor | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-28 |
| 1164936126 | Marisol Bonner | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1760906085 | Roberto Sotelo Jr. | Licensed Vocational Nurse | 867 North Fair Oaks Ave., Pasadena, CA 91103 | 2017-07-28 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1437671807 | Yolanda Centeno | Marriage & Family Therapist | 867 Fairoaks., Pasadena, CA 91103 | 2017-07-07 |
| 1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
| 1922537372 | Chaznii Bradford | Licensed Vocational Nurse | 867 N. Fair Oaks, Pasadena, CA 91103 | 2017-06-08 |
| 1629505425 | Wassim Ammary | Pharmacist | 1855 South Fair Oaks Ave, Pasadena, CA 91103 | 2017-05-11 |
| 1679005920 | Grace Caroline Seto | Marriage & Family Therapist | 236 W. Mountain St, Suite 202d, Pasadena, CA 91103 | 2017-03-28 |
| 1225575293 | Catherine Lynn Gray | Psychologist | 30 North Raymond Avenue, Suite 403, Pasadena, CA 91103 | 2017-01-27 |
| Find all providers in zip 91103 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545742 | Travis Jones | Pharmacist | 6767 Spencer Highway, Pasadena, TX 77505 | 2020-10-16 |
| 1629632286 | Janel Elane Reyes Berberabe | Pharmacist | 1722 Asbury Dr, Pasadena, CA 91104-3116 | 2019-04-29 |
| 1902154545 | Ragie Aboulhosn | Pharmacist | 960 E Green St Ste 152, Pasadena, CA 91106-2411 | 2012-08-28 |
| 1831324516 | Sherry Lynn Butler | Pharmacist | 8048 Ritchie Hwy, Pasadena, MD 21122-1084 | 2009-05-24 |
| 1962019372 | Jisha George | Pharmacist | 2619 Red Bluff Rd, Pasadena, TX 77506-5270 | 2020-09-29 |
| 1215541347 | Jesus Gonzalez Jr. | Pharmacist | 2619 Red Bluff Rd, Pasadena, TX 77506-5270 | 2020-09-05 |
| 1093329195 | Divya M Manavalan | Pharmacist | 2619 Red Bluff Rd, Pasadena, TX 77506-5270 | 2020-09-04 |
| 1972127124 | Michelle Tan | Pharmacist | 3550 Spencer Hwy, Pasadena, TX 77504-1110 | 2020-06-03 |
| 1154954006 | Kenneth W Abel | Pharmacist | 2619 Red Bluff Rd, Pasadena, TX 77506-5270 | 2020-02-19 |
| 1306477526 | Ava Deyon | Pharmacist | 2619 Red Bluff Rd, Pasadena, TX 77506-5270 | 2020-01-27 |
| Find all providers in PASADENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.