Healthcare Provider Details

I. General information

NPI: 1124731278
Provider Name (Legal Business Name): THE COMPLETE HUMAN CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29751 N EL MIRAGE RD UNIT 105
PEORIA AZ
85383-6803
US

IV. Provider business mailing address

29751 N EL MIRAGE RD UNIT 105 PMB 131
PEORIA AZ
85383
US

V. Phone/Fax

Practice location:
  • Phone: 510-529-7768
  • Fax:
Mailing address:
  • Phone: 510-529-7768
  • Fax: 302-400-8118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHELL HUYNH
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 510-239-6698