Provider Demographics
NPI:1043322449
Name:NGUYEN, CECILIA KIEUHANH (RPH)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:KIEUHANH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:KIEUHANH
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:118 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1279
Mailing Address - Country:US
Mailing Address - Phone:925-831-1409
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2504
Practice Address - Fax:925-372-2760
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040978183500000X
NV14302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist