MEDICARE: MONA MASCARENAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2025060374	AZ

General Provider Information

NPI Number	:	1730035601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONA MASCARENAS

Provider Business Mailing Address
First Line	:	10240 N 31ST AVE STE 125
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10240 N 31ST AVE STE 125
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9599
Country	:	US
Telephone Number	:	623-810-8515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ MONA MASCARENAS ” Practice Location

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