Healthcare Provider Details

I. General information

NPI: 1063325587
Provider Name (Legal Business Name): THU NGAN NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 E CYPRESS AVE
REDDING CA
96002-1114
US

IV. Provider business mailing address

2244 EMERALD HILLS CIR
SAN JOSE CA
95131-2611
US

V. Phone/Fax

Practice location:
  • Phone: 530-221-5575
  • Fax:
Mailing address:
  • Phone: 209-779-4816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: