Healthcare Provider Details

I. General information

NPI: 1871695338
Provider Name (Legal Business Name): LISA JEAN ADAMS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 E CLINTON AVE
FRESNO CA
93703-2223
US

IV. Provider business mailing address

1203 W SCOTT AVE
FRESNO CA
93711-3121
US

V. Phone/Fax

Practice location:
  • Phone: 559-225-6100
  • Fax: 559-241-6482
Mailing address:
  • Phone: 559-438-6110
  • Fax: 559-438-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH43615
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberRPH43615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: