Provider Demographics
NPI:1811202799
Name:JAMES, LISA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:JAMES
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 1:10461 AVENIDA MAGNIFICA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1403
Mailing Address - Country:US
Mailing Address - Phone:858-368-9336
Mailing Address - Fax:
Practice Address - Street 1:4168 FRONT ST RM 1-127
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2030
Practice Address - Country:US
Practice Address - Phone:858-543-5943
Practice Address - Fax:619-543-6784
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 38327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist