Healthcare Provider Details

I. General information

NPI: 1932361540
Provider Name (Legal Business Name): JENNIFER HUYNH PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 MAGNOLIA AVE
RIVERSIDE CA
92505-3043
US

IV. Provider business mailing address

13310 NORTON AVE
CHINO CA
91710-4903
US

V. Phone/Fax

Practice location:
  • Phone: 951-321-7000
  • Fax:
Mailing address:
  • Phone: 909-631-6043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number54833
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: