Healthcare Provider Details

I. General information

NPI: 1285974907
Provider Name (Legal Business Name): VALERIE HANH MY NGO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2013
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3548 SILVERWOOD RD
WEST SACRAMENTO CA
95691-5455
US

IV. Provider business mailing address

3548 SILVERWOOD RD
WEST SACRAMENTO CA
95691-5455
US

V. Phone/Fax

Practice location:
  • Phone: 925-335-7474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: