Provider Demographics
NPI:1952027831
Name:AMINI, NAWENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NAWENA
Middle Name:
Last Name:AMINI
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 1:10234 ARROW ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3620
Mailing Address - Country:US
Mailing Address - Phone:858-717-1036
Mailing Address - Fax:
Practice Address - Street 1:875 E H ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7807
Practice Address - Country:US
Practice Address - Phone:619-205-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist