Healthcare Provider Details

I. General information

NPI: 1235872383
Provider Name (Legal Business Name): HENRY MONROE GUAJARDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 E CHANDLER BLVD STE 200 PRIVATE OFFICE 222
PHOENIX AZ
85048-7651
US

IV. Provider business mailing address

4435 E CHANDLER BLVD STE 200 PRIVATE OFFICE 222
PHOENIX AZ
85048-7651
US

V. Phone/Fax

Practice location:
  • Phone: 833-351-8255
  • Fax:
Mailing address:
  • Phone: 833-351-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number79450
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: