Provider Demographics
NPI:1962066332
Name:WONG-SING, JANETTE (RPH)
Entity type:Individual
Prefix:
First Name:JANETTE
Middle Name:
Last Name:WONG-SING
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 1:40560 ROAD 36
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-9621
Mailing Address - Country:US
Mailing Address - Phone:559-859-0461
Mailing Address - Fax:
Practice Address - Street 1:1825 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-3705
Practice Address - Country:US
Practice Address - Phone:558-875-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH30239333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy