Healthcare Provider Details

I. General information

NPI: 1043322449
Provider Name (Legal Business Name): CECILIA KIEUHANH NGUYEN R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIEUHANH THI NGUYEN B.S.

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MUIR RD
MARTINEZ CA
94553-4668
US

IV. Provider business mailing address

118 WOODCREST DR
SAN RAMON CA
94583-1279
US

V. Phone/Fax

Practice location:
  • Phone: 925-372-2504
  • Fax: 925-372-2760
Mailing address:
  • Phone: 925-831-1409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00040978
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14302
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: