MRS. MARLENE LIBBY WALLIS (NPI# 1831625912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831625912 |
| Entity Type | Individual |
| Full Name | MRS. MARLENE LIBBY WALLIS |
| Credential | RPH |
| Practice Address |
7081 Svl Box Victorville CA 92395-5108 |
| Practice Telephone | 7606173190 |
| Mailing Telephone | 7606173190 |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 32296 | CA | Pharmacy Service Providers |
| Street Address |
7081 SVL BOX |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-5108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619484292 | Cam Quyen Nguyen | Pharmacist | 13178 Aurora Ave, Victorville, CA 92392-5038 | 2018-01-04 |
| 1215442793 | Yun Jung Choi | Pharmacist | 15318 Roy Rogers Dr., Victorville, CA 92394 | 2017-12-06 |
| 1134575376 | Seth Owuor | Pharmacist | 14426 Palmdale Road, Victorville, CA 92308 | 2016-05-06 |
| 1760858583 | Fahad Muwanas | Pharmacist | 13235 Sundance Cir, Victorville, CA 92392-6655 | 2015-08-16 |
| 1962893529 | Mildred Davis | Pharmacist | 16138 Evansdale Way, Victorville, CA 92395-9531 | 2015-02-18 |
| 1922411560 | Christina Chung | Pharmacist | 14515 Mojave Dr Ste B, Victorville, CA 92394-6762 | 2014-06-10 |
| 1588088058 | Frank Wong | Pharmacist | 7487 Svl Box, Victorville, CA 92395-5157 | 2014-02-04 |
| 1962771907 | Vrunda K Patel | Pharmacist | 7339 Svl Box, Victorville, CA 92395-5155 | 2011-12-20 |
| 1700192374 | Danggiao Phan | Pharmacist | 13255 Rolling Hills Rd, Victorville, CA 92395-8622 | 2010-08-20 |
| 1336453117 | Tony Ibrahim | Pharmacist | 14629 7th St, Victorville, CA 92395-4019 | 2010-08-04 |
| Find all providers in VICTORVILLE | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
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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.