Healthcare Provider Details

I. General information

NPI: 1740192657
Provider Name (Legal Business Name): ANNALISA AU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 N WILLOW AVE
CLOVIS CA
93611-4408
US

IV. Provider business mailing address

6107 E ANDREWS AVE
FRESNO CA
93727-8900
US

V. Phone/Fax

Practice location:
  • Phone: 559-322-0340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: