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General NPI Number Information
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NPI Number | 1003475302
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Entity Type | Individual
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Provider Name | JOSCELYN D. A. C. AQUININGOC PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 101 BODIN CIR
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City | TRAVIS AFB
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State | CA
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Zip | 94535-1809
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Country | US
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Telephone | 626-297-8649
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Fax |
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Provider Business Mailing Address
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Address Line | 10362 S GOLDEN WILLOW DR
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City | SANDY
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State | UT
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Zip | 84070-4238
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Country | US
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Telephone | 626-297-8649
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10122676-1702
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License Number State | UT
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