Healthcare Provider Details

I. General information

NPI: 1740158716
Provider Name (Legal Business Name): BRIANNA JUSTINE NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/30/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 W COVELL BLVD
DAVIS CA
95616-5645
US

IV. Provider business mailing address

PO BOX 276672
SACRAMENTO CA
95827-6672
US

V. Phone/Fax

Practice location:
  • Phone: 530-747-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number888944
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: