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General NPI Number Information
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NPI Number | 1659631067
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Entity Type | Individual
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Provider Name | XIAOJUAN YUAN PHARM.D, BCPP, APH
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Gender | Female
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1161 E COVINA BLVD
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City | COVINA
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State | CA
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Zip | 91724-1523
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Country | US
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Telephone | 626-589-5218
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Fax |
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Provider Business Mailing Address
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Address Line | 1161 E COVINA BLVD
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City | COVINA
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State | CA
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Zip | 91724-1523
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Country | US
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Telephone | 510-789-8038
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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 | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 63041
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 63041
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 63041
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 10091
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License Number State | CA
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