Healthcare Provider Details

I. General information

NPI: 1467960773
Provider Name (Legal Business Name): CLARISSA MICHELLE SAENZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2018
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18275 N 59TH AVE STE 138
GLENDALE AZ
85308-1253
US

IV. Provider business mailing address

18275 N 59TH AVE STE 138
GLENDALE AZ
85308-1253
US

V. Phone/Fax

Practice location:
  • Phone: 602-546-0078
  • Fax:
Mailing address:
  • Phone: 602-564-0078
  • Fax: 602-564-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6914
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: