Healthcare Provider Details

I. General information

NPI: 1336010974
Provider Name (Legal Business Name): JESSICA KIM VU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21255 BURBANK BLVD STE 150
WOODLAND HILLS CA
91367-6674
US

IV. Provider business mailing address

21425 VANOWEN ST APT 526
CANOGA PARK CA
91303-2773
US

V. Phone/Fax

Practice location:
  • Phone: 877-608-0082
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH89978
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: