Provider Demographics
NPI:1003227943
Name:SITRONETO, LEISA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:LEISA
Middle Name:ANN
Last Name:SITRONETO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 LUCCA LN
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-2052
Mailing Address - Country:US
Mailing Address - Phone:775-358-7220
Mailing Address - Fax:775-689-2438
Practice Address - Street 1:2200 HARVARD WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-689-2211
Practice Address - Fax:775-689-2438
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9957183500000X
AZ7464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist