Healthcare Provider Details

I. General information

NPI: 1477418325
Provider Name (Legal Business Name): TRICIA LE NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N FAIR OAKS AVE UNIT 2104
PASADENA CA
91103-0609
US

IV. Provider business mailing address

3378 BEL MIRA WAY
SAN JOSE CA
95135-2358
US

V. Phone/Fax

Practice location:
  • Phone: 408-693-1965
  • Fax:
Mailing address:
  • Phone: 408-693-1965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: