Healthcare Provider Details

I. General information

NPI: 1255925632
Provider Name (Legal Business Name): JOSELITO G. SAYCO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2021
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 N ROCHESTER DR
GILBERT AZ
85234-1472
US

IV. Provider business mailing address

1502 N ROCHESTER DR
GILBERT AZ
85234-1472
US

V. Phone/Fax

Practice location:
  • Phone: 480-577-0366
  • Fax: 480-687-2841
Mailing address:
  • Phone: 480-577-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberAZ12220
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberD055116420
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: