Healthcare Provider Details

I. General information

NPI: 1174846000
Provider Name (Legal Business Name): JEAN DIANE DAL PONTE PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2010
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10450 N LA CANADA DR
TUCSON AZ
85737-7027
US

IV. Provider business mailing address

10450 N LA CANADA DR
TUCSON AZ
85737-7027
US

V. Phone/Fax

Practice location:
  • Phone: 520-877-9269
  • Fax: 520-531-8281
Mailing address:
  • Phone: 520-877-9269
  • Fax: 520-531-8281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number11947
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: