Healthcare Provider Details

I. General information

NPI: 1568185015
Provider Name (Legal Business Name): KAYLA NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 DISCOVERY DR STE 250
BAKERSFIELD CA
93309-7076
US

IV. Provider business mailing address

11809 TRACKSIDE DR
BAKERSFIELD CA
93312-8243
US

V. Phone/Fax

Practice location:
  • Phone: 661-852-3590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH86773
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH86773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: