Healthcare Provider Details

I. General information

NPI: 1093625550
Provider Name (Legal Business Name): SELENA RIOS TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 W CARLA VISTA DR UNIT 6721
CHANDLER AZ
85246-4030
US

IV. Provider business mailing address

1900 W CARLA VISTA DR UNIT 6721
CHANDLER AZ
85246-4030
US

V. Phone/Fax

Practice location:
  • Phone: 928-750-6423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number252900
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: