Provider Demographics
NPI:1770681801
Name:ENGLERT, LISA LINNEA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:LINNEA
Last Name:ENGLERT
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 1:521 PARNASSUS AVE
Mailing Address - Street 2:RM C-152 BOX 0622
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2206
Mailing Address - Country:US
Mailing Address - Phone:415-353-8801
Mailing Address - Fax:415-353-1411
Practice Address - Street 1:965 DOLORES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2922
Practice Address - Country:US
Practice Address - Phone:415-353-8801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist