SOPHIA YOONJUNG PARK (NPI# 1881976876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881976876 |
| Entity Type | Individual |
| Full Name | SOPHIA YOONJUNG PARK |
| Credential | PHARM.D |
| Practice Address |
80b Veterans Blvd Acoma NM 87034 |
| Mailing Address |
Po Box 130 San Fidel NM 87049-0130 |
| Practice Telephone | 5055525394 |
| Mailing Telephone | 5055525394 |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
19766 | MD | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343828 | Sophia Park | Speech-Language Pathologist | 1 Abele Dr, Clifton Park, NY 12065-2951 | 2020-10-16 |
| 1427693357 | Sophia Park | Marriage & Family Therapist | 600 N Jackson St Ste 300, Media, PA 19063-2530 | 2019-11-14 |
| 1255632212 | Sophia Park | Pharmacist | 2684 N Tustin St, Orange, CA 92865-2438 | 2010-11-08 |
| Street Address |
80B VETERANS BLVD |
| City | ACOMA |
| State | NM |
| Zip Code | 87034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629421755 | Angela Kao | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2016-07-13 |
| 1043638521 | Xing Yang | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2014-04-02 |
| 1801220074 | Anwyn Pritchard | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2013-08-23 |
| 1457793143 | Nathan Gonzales | Emergency Medical Technician, Paramedic | 80b Veterans Blvd, Acl Ihs, Acoma, NM 87034 | 2013-07-23 |
| 1588949093 | Alexander P Varga | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2011-10-15 |
| 1821371840 | Brian Tieu | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2011-09-26 |
| 1215210703 | Mindy Chou | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2011-09-21 |
| 1164694808 | Yvonne Lutter | Psychologist | 80b Veterans Blvd, Acoma, NM 87034 | 2008-04-01 |
| 1912183393 | Venetta Joi Thompson | Nurse Practitioner | 80b Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 | 2008-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535192 | Troy Stephen Weeldreyer | Social Worker | 45 Pinsbaari Dr, Acoma, NM 87034 | 2020-07-16 |
| 1306486857 | Mallery Chino | Case Manager/Care Coordinator | 47 Pinsbarri Drive, Acoma, NM 87034 | 2020-01-13 |
| 1700340841 | Thomas Simon Vallo | Case Manager/Care Coordinator | 45 Pinbaari Drive, Acoma, NM 87034 | 2019-01-23 |
| 1649777053 | Amanda Jean Garcia | Counselor | 99b Sunrise Rd, Pueblo of Acoma, NM 87034 | 2018-04-11 |
| 1356850754 | Korey B Still | Dentist | 80 B Veterans Blvd., Acoma, NM 87034 | 2017-09-28 |
| 1508395278 | Shelby Bobelu | Social Worker | 45 Pinsbarri Dr., Acoma, NM 87034 | 2017-06-07 |
| 1558817270 | Amanda Lucario | Technician, Other | 1253 Haaku Road, Acoma, NM 87034 | 2016-09-01 |
| 1073961355 | Rhayna Dannielle Walizer | Social Worker | 45 Pinsbarri Dr, Acoma, NM 87034 | 2016-05-27 |
| 1417305715 | Everett Chavez | Counselor | 45 Pinsbaari, Acoma, NM 87034 | 2016-05-26 |
| 1952758047 | Lonnie Lewis | Counselor | 33 Pinsbaari Drive, Acoma, NM 87034 | 2016-05-18 |
| Find all providers in zip 87034 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588949093 | Alexander P Varga | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2011-10-15 |
| 1215210703 | Mindy Chou | Pharmacist | 80b Veterans Blvd, Acoma, NM 87034 | 2011-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426016 | Natalia Carmen Mendez | Pharmacist | 409 Kathleen Pl, Farmington, NM 87401-3535 | 2020-08-04 |
| 1346897162 | Kali Autrey | Pharmacist | Junction Hwy 371 and Rt 9, Crownpoint, NM 87313 | 2019-08-26 |
| 1831752286 | Eillim De Jesus Rentas | Pharmacist | 6301 Alameda Blvd Ne Unit 1051, Albuquerque, NM 87113-2583 | 2019-04-20 |
| 1124594148 | Danielle Schavz | Pharmacist | 1691 Galisteo St Ste A, Santa Fe, NM 87505-4781 | 2018-10-17 |
| 1720589336 | Colin Wingfield Williams | Pharmacist | 8100 Constitution Pl Ne Ste 300, Albuquerque, NM 87110-7643 | 2018-02-28 |
| 1720501489 | Julia Poynor Lawrence | Pharmacist | 2705 Highland Rd, Roswell, NM 88201-1330 | 2017-07-24 |
| 1780030973 | Welly Agate | Pharmacist | U.S. Hwy. 491 North, Shiprock, NM 87420-0160 | 2016-05-06 |
| 1467836502 | Quentin Cooper Florence | Pharmacist | 44 Calle Del Media, Tijeras, NM 87059 | 2015-07-18 |
| 1669855698 | Krystle Tapia | Pharmacist | 601 Menaul Blvd Ne, Unit 203, Albuquerque, NM 87107-1531 | 2015-07-08 |
| 1386044006 | Richard Groh | Pharmacist | 905 Saunders Dr, Roswell, NM 88201-1002 | 2014-08-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOPHIA YOONJUNG PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.