Provider Demographics
NPI:1134712029
Name:MARIS, TRISHA MAI-TRINH (RPH)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:MAI-TRINH
Last Name:MARIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:MAI-TRINH
Other - Last Name:HUFNAGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:3600 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2066
Mailing Address - Country:US
Mailing Address - Phone:626-280-4908
Mailing Address - Fax:
Practice Address - Street 1:3600 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2066
Practice Address - Country:US
Practice Address - Phone:626-280-4908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH53465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist