DR. ANDREA ELLEN FORMELLA (NPI# 1730664293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730664293 |
| Entity Type | Individual |
| Full Name | DR. ANDREA ELLEN FORMELLA |
| Other Name | DR. ANDREA ELLEN EGGERT |
| Credential | PHARMD |
| Practice Address |
28652 Malabar Rd Trabuco Canyon CA 92679-1622 |
| Practice Telephone | 5127967547 |
| Mailing Telephone | 5127967547 |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 11223-40 | WI | Pharmacy Service Providers |
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
11223-40 | WI | Pharmacy Service Providers |
| Street Address |
28652 MALABAR RD |
| City | TRABUCO CANYON |
| State | CA |
| Zip Code | 92679-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839834 | Natalia Locati | Technician, Other | 20338 Flanagan Rd, Rancho Santa Margarita, CA 92679 | 2019-12-23 |
| 1720620289 | Shaley Gupta | Pharmacist | 21 Centaurus Way, Coto De Caza, CA 92679 | 2019-10-16 |
| 1598135147 | Jenna Lynn Zottarelli | Counselor | 20342 Flanagan Road, Trabuco Canyon, CA 92679 | 2015-09-25 |
| 1033596226 | Kristina Murphy | Counselor | 100 Via Candelaria, Coto De Caza, CALIFORNIA 92679 | 2015-04-27 |
| 1467790576 | Lucito Gamboa Gamboa | Family Medicine | 18 Golfview Drive, Dove Canyon, CA 92679 | 2013-01-24 |
| 1235407131 | Karen Ebersole Rippy | Marriage & Family Therapist | 20331 Flanagan Rd., Trabuco Canyon, CA 92679 | 2011-12-06 |
| 1255655916 | Lyndsay Allison Bulger | Registered Nurse | 15 Glen Echo, Dove Canyon, CA 92679 | 2010-03-23 |
| 1235393133 | Kalapp Chiropractic | Chiropractor | 20061 Trabuco Oaks, Trabuco Canyon, CA 92679 | 2008-07-10 |
| 1760650071 | Reha C Shrikhande | Physical Therapist | 8 Yellowpine Lane, Trabuco Cyn, CA 92679 | 2008-02-20 |
| 1013012343 | Robert J Foster | Physical Therapist | 28351 Quiet Hill Lane, Trabuco Canyon, CA 92679 | 2006-09-13 |
| Find all providers in zip 92679 | ||||
| Taxonomy Code | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205457918 | Abdulla Nooristani | Pharmacist | 3630 Business Dr Ste D, Sacramento, CA 95820-2179 | 2020-05-04 |
| 1811534878 | Susan Lee | Pharmacist | 9362 Canterbury Ln, Garden Grove, CA 92841-3415 | 2019-12-09 |
| 1669963294 | Geoffrey Charles Henrietta | Pharmacist | 19205 Almond Rd, Castro Valley, CA 94546-3033 | 2018-05-18 |
| 1689034498 | Meredyth Keast-devine | Pharmacist | 4875 Shadow Canyon Rd Bldg B, Templeton, CA 93465-9714 | 2016-03-07 |
| 1922330638 | Christopher Ching | Pharmacist | 1380 Howard St # 130, San Francisco, CA 94103-2638 | 2010-02-04 |
| 1588856850 | Luriko Jean Ajari | Pharmacist | 2356 Sutter Street, Fourth Floor, San Francisco, CA 94115-1648 | 2007-08-10 |
| 1104020841 | Mark David Watanabe | Pharmacist | 1380 Howard St Rm 130, San Francisco, CA 94103 | 2007-06-14 |
| 1568672400 | Van Viet Do | Pharmacist | 2418 Hummel Ct, San Jose, CA 95148-2510 | 2007-05-22 |
| 1861610693 | Bruce David Miller | Pharmacist | 3057 S Higuera St, Spc # 53, San Luis Obispo, CA 93401-6625 | 2007-04-24 |
| 1316009830 | Michael Francis Pondrom | Pharmacist | 590 N Vermont Ave, Los Angeles, CA 90004-2115 | 2006-12-14 |
| Find all providers with the same taxonomy | ||||
| City | TRABUCO CANYON |
| Zip Code | 92679 |
Please comment or provide details below to improve the information on DR. ANDREA ELLEN FORMELLA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.