Healthcare Provider Details

I. General information

NPI: 1659839942
Provider Name (Legal Business Name): ADENA NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2019
Last Update Date: 03/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E LERDO HWY
SHAFTER CA
93263-2702
US

IV. Provider business mailing address

15781 LAS SOLANAS ST
WESTMINSTER CA
92683-7026
US

V. Phone/Fax

Practice location:
  • Phone: 661-746-4991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: