Healthcare Provider Details

I. General information

NPI: 1457230971
Provider Name (Legal Business Name): SASHA ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13838 S 46TH PL STE 320
PHOENIX AZ
85044-7804
US

IV. Provider business mailing address

13838 S 46TH PL STE 320
PHOENIX AZ
85044-7804
US

V. Phone/Fax

Practice location:
  • Phone: 480-759-5151
  • Fax:
Mailing address:
  • Phone: 480-759-5151
  • Fax: 480-940-8649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11194
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: