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Rose Ellis, RPH
Nutrition Support Pharmacist in Stockton, California
NPI 1750363636

Rose Ellis is a Nutrition Support Pharmacist based in Lodi, CA and is specialized in Nutrition Support. Rose Ellis practices in Stockton, CA and has the professional credentials of RPH. The NPI Number for Rose Ellis is 1750363636 and holds a License No. 30597 (California).

The current practice location address for Rose Ellis is 1800 N California St, Stockton, CA and can be reached out via phone at 209-461-5486 and via fax at 209-461-6890. You can also correspond with Rose Ellis through the mailing address at 1200 S SUNSET DR, LODI, CA - 95240-5532 (mailing address contact number: 209-595-7147).

Location: 1800 N California St, Stockton, CA, 95240-5532
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750363636
Provider Name
Rose Ellis
Credential
RPH
Provider Entity Type
Individual
Gender
Female
Address
1800 N California St, Stockton, CA, 95240-5532
Phone Number
209-461-5486
Fax Number
209-461-6890
Provider Enumeration Date
11/16/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30597 01 CA CALIF. LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
1800 N California St
City
Stockton
State
California
Zip
95204-6019
Phone Number
209-461-5486
Fax Number
209-461-6890
person
Provider Business Mailing Address Details
Address
1200 S Sunset Dr
City
Lodi
State
California
Zip
95240-5532
Phone Number
209-595-7147
Fax Number
209-461-6890
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
-
Taxonomy
183500000X
License No.
30597 (California)
Definition
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.
person
Provider's Taxonomy Details 2
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
Nutrition Support
Taxonomy
1835N1003X
License No.
30597 (California)
Definition
A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs.
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