Provider Demographics
NPI:1518288224
Name:LAURENT, DIANA LYNN SMITH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:LYNN SMITH
Last Name:LAURENT
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 1:689 E NEES AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2106
Mailing Address - Country:US
Mailing Address - Phone:559-439-1190
Mailing Address - Fax:559-439-1655
Practice Address - Street 1:689 E NEES AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-439-1190
Practice Address - Fax:559-439-1655
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11431183500000X
CA454231835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist