MEDICARE: SANOVA BEHAVIORAL HEALTH PLLC

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

General Provider Information

NPI Number	:	1871458786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANOVA BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	7959 N THORNYDALE RD # 89520
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-1443
Country	:	US
Telephone Number	:	520-317-6805
Fax Number	:	520-363-6153

Provider Business Practice Location Address
First Line	:	15883 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85739-9202
Country	:	US
Telephone Number	:	520-317-6805
Fax Number	:	520-363-6153

Authorized Official
Title or Position	:	OWNER
Name	:	KIYAN RAD
Credential	:	D.O
Telephone Number	:	520-201-6990

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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