Provider Demographics
NPI:1215262902
Name:GOLDSTONE, LISA W (MS, PHARMD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:W
Last Name:GOLDSTONE
Suffix:
Gender:F
Credentials:MS, PHARMD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:WHITTINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PHARMD
Mailing Address - Street 1:4525 E SKYLINE DR
Mailing Address - Street 2:#114
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1666
Mailing Address - Country:US
Mailing Address - Phone:520-395-5277
Mailing Address - Fax:
Practice Address - Street 1:4525 E SKYLINE DR
Practice Address - Street 2:#114
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1666
Practice Address - Country:US
Practice Address - Phone:520-395-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-11782101YP2500X
AZS016098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No183500000XPharmacy Service ProvidersPharmacist