Healthcare Provider Details

I. General information

NPI: 1265828735
Provider Name (Legal Business Name): KATSUKO NAGAYOSHI CLEYMAET DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATSUKO NAGAYOSHI DO

II. Dates (important events)

Enumeration Date: 04/12/2015
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5102 W CAMPBELL AVE
PHOENIX AZ
85031-1703
US

IV. Provider business mailing address

2929 E THOMAS RD
PHOENIX AZ
85016-8034
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-5011
  • Fax: 602-655-1951
Mailing address:
  • Phone: 602-470-5000
  • Fax: 602-470-5064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS020077
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number012048
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: