Healthcare Provider Details

I. General information

NPI: 1134972755
Provider Name (Legal Business Name): BIANCA NICOLE OGUES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E TACHEVAH DR STE 2E204
PALM SPRINGS CA
92262-5737
US

IV. Provider business mailing address

555 E TACHEVAH DR STE 2W103
PALM SPRINGS CA
92262-5748
US

V. Phone/Fax

Practice location:
  • Phone: 760-561-7373
  • Fax:
Mailing address:
  • Phone: 760-464-0023
  • Fax: 833-973-4790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH85362
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: