Active NPI
Anna Lissa Lim Andaya, RPH
- Pharmacist
- Tracy, CA
National Provider Identifier
1730478702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 63541
- Practice address
- 1970 W Grant Line Rd
Tracy, CA 95376-8812 - Phone
- (209) 830-7388
- Fax
- (209) 830-8405
- NPI assigned
- Mar 30, 2011
- Last updated
- Mar 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 63541 | CA | Primary |
Addresses
Primary practice location
1970 W Grant Line Rd
Tracy, CA 95376-8812
Mailing address
7350 W Rena Dr
Tracy, CA 95304-8180
Phone (209) 762-2865
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 63541 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rite Aid Pharmacy 06833
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301443200000",
"number": "1730478702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7350 W RENA DR",
"city": "TRACY",
"state": "CA",
"postal_code": "953048180",
"telephone_number": "209-762-2865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 W GRANT LINE RD",
"city": "TRACY",
"state": "CA",
"postal_code": "953768812",
"telephone_number": "209-830-7388",
"fax_number": "209-830-8405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDAYA",
"first_name": "ANNA LISSA",
"middle_name": "LIM",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-30",
"last_updated": "2011-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 63541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
- Ameriprime Healthcare Inc. (Ameriprime Hospice Care)
- Fazila Amin
- Amrit S Basi DMD Corp (Millennium Dental of Tracy)
- Amrit S Basi DMD Corp (Central Dental Care)
- Lakshay Anand
- Carol Roberta Anderson, PH.D.
- Paul Roger Anderson, PA
- Miguel Andrade Salcedo
- Ralph Douglas Andrade, DC
- Melinda Contreras Andres, MFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.