Healthcare Provider Details

I. General information

NPI: 1447634977
Provider Name (Legal Business Name): CARISSA CHRISTINE FERNANDEZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 S 16TH AVE
TUCSON AZ
85713-6001
US

IV. Provider business mailing address

3640 S 16TH AVE
TUCSON AZ
85713-6001
US

V. Phone/Fax

Practice location:
  • Phone: 520-624-6936
  • Fax: 520-623-9475
Mailing address:
  • Phone: 520-624-6936
  • Fax: 520-623-9475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS021315
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021315
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: