Healthcare Provider Details

I. General information

NPI: 1306950407
Provider Name (Legal Business Name): ROGELIO D. NARANJA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 HIGHWAY 95 STE 104
BULLHEAD CITY AZ
86442-7802
US

IV. Provider business mailing address

59 COYOTE HILLS ST
HENDERSON NV
89012-4460
US

V. Phone/Fax

Practice location:
  • Phone: 928-763-0250
  • Fax: 928-763-0271
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13156
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number13156
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: