Healthcare Provider Details

I. General information

NPI: 1720570682
Provider Name (Legal Business Name): STEPHANIE IRENE AMAYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE CARDENAS

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N 12TH ST FL 3
PHOENIX AZ
85006-2837
US

IV. Provider business mailing address

1441 N 12TH ST FL 3
PHOENIX AZ
85006-2837
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-5700
  • Fax:
Mailing address:
  • Phone: 602-521-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA180601
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number75935
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207VC0300X
TaxonomyComplex Family Planning Physician
License NumberA180601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: