Provider Demographics
NPI:1720352263
Name:HUANG, JENNIFER L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
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 1:1 ORCHARD
Mailing Address - Street 2:#215
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8337
Mailing Address - Country:US
Mailing Address - Phone:619-661-6500
Mailing Address - Fax:619-671-7588
Practice Address - Street 1:1 ORCHARD
Practice Address - Street 2:#215
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8337
Practice Address - Country:US
Practice Address - Phone:619-661-6500
Practice Address - Fax:619-671-7588
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist