Healthcare Provider Details

I. General information

NPI: 1932100419
Provider Name (Legal Business Name): ELIZABETH F BANKS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 GASLIGHT DR
MODESTO CA
95355-8104
US

IV. Provider business mailing address

2008 GASLIGHT DR
MODESTO CA
95355-8104
US

V. Phone/Fax

Practice location:
  • Phone: 209-551-3419
  • Fax:
Mailing address:
  • Phone: 209-551-3419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55672
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17059
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34457
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number010005
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number55672
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number17059
License Number StateLA
# 7
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number34457
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number010005
License Number StateSC
# 9
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number55672
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17059
License Number StateLA
# 11
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number34457
License Number StateFL
# 12
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number010005
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: