Provider Demographics
NPI:1194479816
Name:YEUNG, JENNY (RPH)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:YEUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5169 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2453
Mailing Address - Country:US
Mailing Address - Phone:626-383-2889
Mailing Address - Fax:
Practice Address - Street 1:1108 S BALDWIN AVE # 8
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7508
Practice Address - Country:US
Practice Address - Phone:626-445-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH44997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist