Healthcare Provider Details

I. General information

NPI: 1225947286
Provider Name (Legal Business Name): SELINA JIN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24790 VALLEY ST
SANTA CLARITA CA
91321-2629
US

IV. Provider business mailing address

24790 VALLEY ST
SANTA CLARITA CA
91321-2629
US

V. Phone/Fax

Practice location:
  • Phone: 661-670-2020
  • Fax:
Mailing address:
  • Phone: 661-670-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH92989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: