Healthcare Provider Details

I. General information

NPI: 1114845963
Provider Name (Legal Business Name): TUYEN VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7656 MALTA DR
ROSEVILLE CA
95678-6052
US

IV. Provider business mailing address

7656 MALTA DR
ROSEVILLE CA
95678-6052
US

V. Phone/Fax

Practice location:
  • Phone: 916-206-5951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number73298
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: