Healthcare Provider Details

I. General information

NPI: 1487062717
Provider Name (Legal Business Name): STEPHANIE ANGELA LIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20000 RINALDI ST
PORTER RANCH CA
91326-4900
US

IV. Provider business mailing address

11541 SASSARI LN
PORTER RANCH CA
91326-4402
US

V. Phone/Fax

Practice location:
  • Phone: 818-509-5394
  • Fax:
Mailing address:
  • Phone: 858-692-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: