Provider Demographics
NPI:1518738863
Name:CRUZ, ADRIANNE DENISE (RPH)
Entity Type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:DENISE
Last Name:CRUZ
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 1:1326 E PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-5745
Mailing Address - Country:US
Mailing Address - Phone:559-457-9851
Mailing Address - Fax:
Practice Address - Street 1:1326 E PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-5745
Practice Address - Country:US
Practice Address - Phone:559-457-9851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist