Healthcare Provider Details

I. General information

NPI: 1720657703
Provider Name (Legal Business Name): ANA LUCIA FRANCO BOJORQUEZ MC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5008 E OAK ST APT 3
PHOENIX AZ
85008-2531
US

IV. Provider business mailing address

5008 E OAK ST APT 3
PHOENIX AZ
85008-2531
US

V. Phone/Fax

Practice location:
  • Phone: 928-446-6135
  • Fax:
Mailing address:
  • Phone: 928-446-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: