Healthcare Provider Details

I. General information

NPI: 1598534174
Provider Name (Legal Business Name): UYEN TRAN THUY THAI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/25/2023
Last Update Date: 12/25/2023
Certification Date: 12/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 CAPITOL AVE
SACRAMENTO CA
95816-6039
US

IV. Provider business mailing address

5191 SUTTER PARK WAY STE 106
SACRAMENTO CA
95819-3169
US

V. Phone/Fax

Practice location:
  • Phone: 916-887-0000
  • Fax:
Mailing address:
  • Phone: 714-867-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number11166
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number81406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: