=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558240622
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA DUYEN DARAPHET PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2025
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30530 RANCHO CALIFORNIA RD
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92591-3277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-694-0055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30530 RANCHO CALIFORNIA RD
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92591-3277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-694-0055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 91114
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------