Healthcare Provider Details

I. General information

NPI: 1073379566
Provider Name (Legal Business Name): WELLNESS CARE CLINICS OF ARIZONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 W JUANITA AVE STE 216
MESA AZ
85210-6135
US

IV. Provider business mailing address

127 W JUANITA AVE STE 216
MESA AZ
85210-6135
US

V. Phone/Fax

Practice location:
  • Phone: 800-213-9541
  • Fax:
Mailing address:
  • Phone: 800-213-9541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BEVERLY WARFIELD
Title or Position: PART OWNER
Credential: RN
Phone: 469-810-1361