Individual provider Active NPI

Angela Huynh, RPH

  • Pharmacist
  • Tracy, CA
National Provider Identifier
1003297805
Registry record updated Jan 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
72654 Issued in CA
Practice address
2810 S Tracy Blvd
Tracy, CA 95377-8127
Phone
(209) 834-0248
NPI assigned
Jun 17, 2015
Last updated
Jan 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 72654 CA Primary

Addresses

Primary practice location

2810 S Tracy Blvd
Tracy, CA 95377-8127

Mailing address

2810 S Tracy Blvd
Tracy, CA 95377-8127
Phone (209) 834-0248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
72654CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Aug 28, 2022 Accepting new patients
Walgreen Co PastSince Aug 28, 2022 Accepting new patients

Locations

2810 S Tracy Blvd
Tracy, CA 95377
Phone (209) 834-0248

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706313600000",
    "number": "1003297805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 S TRACY BLVD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778127",
            "telephone_number": "209-834-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 S TRACY BLVD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778127",
            "telephone_number": "209-834-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "ANGELA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.