Provider Demographics
NPI:1528411840
Name:DAO, JENNIFER AN-VIEN (DR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AN-VIEN
Last Name:DAO
Suffix:
Gender:F
Credentials:DR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18567 CALLENS CIR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6622
Mailing Address - Country:US
Mailing Address - Phone:714-489-3076
Mailing Address - Fax:562-862-8614
Practice Address - Street 1:8400 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3844
Practice Address - Country:US
Practice Address - Phone:562-861-5460
Practice Address - Fax:562-862-8614
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist