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General NPI Number Information
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NPI Number | 1962968784
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Entity Type | Individual
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Provider Name | JAYME NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 02/17/2019
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Last Update Date | 02/17/2019
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Provider Practice Location Address
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Address Line | 1645 E TULARE AVE
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City | TULARE
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State | CA
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Zip | 93274-3155
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Country | US
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Telephone | 559-688-5839
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Fax |
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Provider Business Mailing Address
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Address Line | 920 N WOODLAND ST APT 202
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City | VISALIA
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State | CA
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Zip | 93291-4766
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Country | US
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Telephone | 714-614-8986
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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 | 80147
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License Number State | CA
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