Healthcare Provider Details

I. General information

NPI: 1902652571
Provider Name (Legal Business Name): ELISA MONIQUE CSADER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 02/09/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1166 E WARNER RD STE 113
GILBERT AZ
85296-3065
US

IV. Provider business mailing address

1166 E WARNER RD STE 113
GILBERT AZ
85296-3065
US

V. Phone/Fax

Practice location:
  • Phone: 480-815-7311
  • Fax: 480-939-5055
Mailing address:
  • Phone: 480-815-7311
  • Fax: 480-939-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number306318
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: