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General NPI Number Information
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NPI Number | 1790385961
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Entity Type | Individual
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Provider Name | HA T NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 13975 MONO WAY STE H
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City | SONORA
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State | CA
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Zip | 95370-2824
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Country | US
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Telephone | 209-677-5424
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Fax | 888-498-0976
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Provider Business Mailing Address
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Address Line | 218 N MAIN ST
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City | SEBASTOPOL
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State | CA
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Zip | 95472-3436
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Country | US
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Telephone | 707-829-3007
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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 | RPH0018136
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH83564
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License Number State | CA
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