Provider Demographics
NPI:1285168054
Name:HUYNH, KATHERINE-HUONG THU (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHERINE-HUONG
Middle Name:THU
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHERINE-HUONG
Other - Middle Name:THU
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4150 GREY CLIFFS CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1980
Mailing Address - Country:US
Mailing Address - Phone:408-272-9156
Mailing Address - Fax:408-272-9197
Practice Address - Street 1:3475 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-2233
Practice Address - Country:US
Practice Address - Phone:408-272-9156
Practice Address - Fax:408-272-9197
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist