Provider Demographics
NPI:1851383673
Name:FAAST, LISA MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:FAAST
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:RAGSDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:13311 NANTUCKET PL
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-6547
Mailing Address - Country:US
Mailing Address - Phone:661-587-8220
Mailing Address - Fax:661-765-5101
Practice Address - Street 1:515 FINLEY DR
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2418
Practice Address - Country:US
Practice Address - Phone:661-765-5111
Practice Address - Fax:661-765-5101
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist