Provider Demographics
NPI:1770851693
Name:NGUYEN, KATHY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:NGUYEN
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 1:2400 MOORPARK AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2624
Mailing Address - Country:US
Mailing Address - Phone:408-282-0500
Mailing Address - Fax:
Practice Address - Street 1:2400 MOORPARK AVE STE 206
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2624
Practice Address - Country:US
Practice Address - Phone:408-282-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH553941835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy