Provider Demographics
NPI:1134279144
Name:HOHENTHANER, LISA (PHARM D)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HOHENTHANER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 SECLUDED LN
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3169
Mailing Address - Country:US
Mailing Address - Phone:530-228-2621
Mailing Address - Fax:
Practice Address - Street 1:14137 LAKERIDGE COURT
Practice Address - Street 2:
Practice Address - City:MAGALIA
Practice Address - State:CA
Practice Address - Zip Code:95954
Practice Address - Country:US
Practice Address - Phone:530-873-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63937183500000X, 1835P1200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy