Individual provider Active NPI

Jonathan Nguyen, PHARMD

  • Pharmacist
  • Simi Valley, CA
National Provider Identifier
1669947578
Registry record updated Oct 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
79521 Issued in CA
Practice address
51 Tierra Rejada Rd
Simi Valley, CA 93065-2902
Phone
(805) 416-5791
NPI assigned
Oct 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 79521 CA Primary

Addresses

Primary practice location

51 Tierra Rejada Rd
Simi Valley, CA 93065-2902

Mailing address

6333 Canoga Ave Apt 302
Woodland Hills, CA 91367-7708
Phone (408) 826-2489

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
79521CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1538784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538784000000",
    "number": "1669947578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 CANOGA AVE APT 302",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677708",
            "telephone_number": "408-826-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 TIERRA REJADA RD",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652902",
            "telephone_number": "805-416-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JONATHAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-06",
        "last_updated": "2018-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "79521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2018; 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.