Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1194311217 Individual Practitioner Male Practitioner

Frederick Evan Broussard , RPH

Pharmacist • La Jolla, CA

Professional Overview & Biography Verified Profile Summary

Frederick Broussard, RPH is a registered healthcare professional specializing in Pharmacist in La Jolla, CA. Practice services are available at 8831 VILLA LA JOLLA DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8831 Villa La Jolla Dr

La Jolla, CA 920371949

Telephone 8584574480
Associated Practice Facility / Clinic
🏢 Garfield Beach Cvs Llc Facility NPI 1194760199

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in La Jolla, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.8 Yrs
Regional Practice Density
185 Specialists

Practicing in La Jolla, CA (33119 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-12-11
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License CA 83939

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID 83938
83938 (CA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Nicole O'donnell , NP

Nurse Practitioner - Family

NPI 1043708456

Nurse Practitioner

NPI 1124578240

Doctor of Pharmacy (Pharm.D.)

NPI 1134057466
Cortney Keckley , FNP-BC

Nurse Practitioner - Family

NPI 1194363770

Family Nurse Practitioner (Board Certified)

NPI 1205394848

Doctor of Pharmacy (Pharm.D.)

Kayla Farahbod , RPH

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI 1205623220

Registered Pharmacist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 13, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location December 13, 2020

Registered at 8831 VILLA LA JOLLA DR, LA JOLLA, CA 920371949 (Tel: 8584574480)

📍
Updated Business Mailing Address December 13, 2020

Registered at 8831 VILLA LA JOLLA DR, LA JOLLA, CA 920371949 (Tel: 8584574480)

👤
Provider Name / Credentials Updated December 13, 2020

Recorded as FREDERICK BROUSSARD, RPH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 13, 2020

Pharmacist (License #83939 in CA)

🟢
Initial NPI Registration & Enumeration December 13, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1194311217
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 13, 2020
Last Update: December 13, 2020
Sole Proprietor: No

Mailing Address

8831 Villa La Jolla Dr

La Jolla, CA 920371949

Phone: 8584574480

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.