Healthcare Provider Details

I. General information

NPI: 1992650055
Provider Name (Legal Business Name): NANCY NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4242 S EL CAMINO REAL
SAN MATEO CA
94403-5133
US

IV. Provider business mailing address

1455 MCCANDLESS DR APT 366
MILPITAS CA
95035-8223
US

V. Phone/Fax

Practice location:
  • Phone: 603-573-5401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: