Individual provider Active NPI

Teresita Huerta Ellazar

  • Pharmacist
  • Fresno, CA
National Provider Identifier
1336035252
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
90860 Issued in CA
Practice address
740 W Alluvial Ave Ste 101
Fresno, CA 93711-5509
Phone
(800) 797-3543
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 90860 CA Primary

Addresses

Primary practice location

740 W Alluvial Ave Ste 101
Fresno, CA 93711-5509

Mailing address

9025 Capricorn Way
San Diego, CA 92126-4711
Phone (619) 672-4353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
90860CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1336035252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9025 CAPRICORN WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264711",
            "telephone_number": "619-672-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W ALLUVIAL AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115509",
            "telephone_number": "800-797-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTA ELLAZAR",
        "first_name": "TERESITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "90860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.