Healthcare Provider Details

I. General information

NPI: 1891014536
Provider Name (Legal Business Name): JESSICA TRAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 FOOTHILL BLVD
LA CANADA CA
91011-3403
US

IV. Provider business mailing address

2037 VERDUGO BLVD
MONTROSE CA
91020-1626
US

V. Phone/Fax

Practice location:
  • Phone: 818-790-5577
  • Fax: 818-790-5580
Mailing address:
  • Phone: 818-248-8018
  • Fax: 818-957-5487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: