Provider Demographics
NPI:1902221955
Name:MAI, YVONNE MY Y THUY (PHARMD)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:MY Y THUY
Last Name:MAI
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:DEPARTMENT OF PHARMACY PRACTICE
Mailing Address - Street 2:3601 PACIFIC AVENUE
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95211-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PHARMACY PRACTICE
Practice Address - Street 2:3601 PACIFIC AVENUE
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95211-0001
Practice Address - Country:US
Practice Address - Phone:209-932-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist