Provider Demographics
NPI:1285954586
Name:NGUYEN, ALENE M (PHARMD)
Entity type:Individual
Prefix:
First Name:ALENE
Middle Name:M
Last Name:NGUYEN
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 1:8368 ELK GROVE FLORIN RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-9228
Mailing Address - Country:US
Mailing Address - Phone:916-681-3558
Mailing Address - Fax:916-681-2893
Practice Address - Street 1:8368 ELK GROVE FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-9228
Practice Address - Country:US
Practice Address - Phone:916-681-3558
Practice Address - Fax:916-681-2893
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH51419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH51419OtherSTATE BOARD OF PHARMACY