Provider Demographics
NPI:1346976529
Name:HARRISON, FAITH DAISY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:DAISY
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 N SHEFFIELD DR UNIT E
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1637
Mailing Address - Country:US
Mailing Address - Phone:714-745-3071
Mailing Address - Fax:
Practice Address - Street 1:2150 N WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1605
Practice Address - Country:US
Practice Address - Phone:760-337-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84274183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist