Healthcare Provider Details

I. General information

NPI: 1346742541
Provider Name (Legal Business Name): SARVA CENTER FOR WELL-BEING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 S VAL VISTA DR STE 137
GILBERT AZ
85295-1681
US

IV. Provider business mailing address

2730 S VAL VISTA DR STE 137
GILBERT AZ
85295-1681
US

V. Phone/Fax

Practice location:
  • Phone: 480-505-3838
  • Fax:
Mailing address:
  • Phone: 480-505-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4574
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-13947
License Number StateAZ

VIII. Authorized Official

Name: DR. AMANDA DEWBRAY
Title or Position: PSYCHOLOGIST
Credential:
Phone: 480-505-3838