Provider Demographics
NPI:1538317961
Name:HUANG, JEN Y (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEN
Middle Name:Y
Last Name:HUANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3721
Mailing Address - Country:US
Mailing Address - Phone:650-324-9515
Mailing Address - Fax:
Practice Address - Street 1:114 LOWELL AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3721
Practice Address - Country:US
Practice Address - Phone:650-324-9515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420141835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH 42014OtherCALIFORNIA STATE BOARD OF PHARMACY