Healthcare Provider Details

I. General information

NPI: 1629996541
Provider Name (Legal Business Name): JULIANNE NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S GRAND AVE
COVINA CA
91724-3236
US

IV. Provider business mailing address

387 MERCED PL
WEST COVINA CA
91790-5027
US

V. Phone/Fax

Practice location:
  • Phone: 626-966-8497
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: