Provider Demographics
NPI:1962631697
Name:TSENG, JANNA
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:TSENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 LUAKINI PL
Mailing Address - Street 2:APT C
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1467
Mailing Address - Country:US
Mailing Address - Phone:808-277-9992
Mailing Address - Fax:
Practice Address - Street 1:453 LUAKINI PL
Practice Address - Street 2:APT C
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1467
Practice Address - Country:US
Practice Address - Phone:808-277-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2018-05-09
Deactivation Date:2014-04-04
Deactivation Code:
Reactivation Date:2018-05-09
Provider Licenses
StateLicense IDTaxonomies
HIPH2680183500000X
WAPH00070412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist