Healthcare Provider Details

I. General information

NPI: 1801708094
Provider Name (Legal Business Name): STEPHANIE NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7096 N WEST AVE
FRESNO CA
93711-0462
US

IV. Provider business mailing address

1837 E TRENTON AVE
FRESNO CA
93720-1987
US

V. Phone/Fax

Practice location:
  • Phone: 559-313-8370
  • Fax:
Mailing address:
  • Phone: 559-313-8370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: