Healthcare Provider Details

I. General information

NPI: 1962636431
Provider Name (Legal Business Name): LISA YVONNE TREHARNE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18571 SOLEDAD CANYON RD SAVON PHARMACY
CANYON COUNTRY CA
91351-3700
US

IV. Provider business mailing address

18571 SOLEDAD CANYON ROAD, SAVON PHARMACY,
CANYON COUNTRY CA
91351
US

V. Phone/Fax

Practice location:
  • Phone: 661-298-0233
  • Fax: 661-298-4912
Mailing address:
  • Phone: 661-298-0233
  • Fax: 661-298-4912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number56445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: