Healthcare Provider Details

I. General information

NPI: 1346594207
Provider Name (Legal Business Name): AMBER D VILLAFANE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 E ELLIOT RD
PHOENIX AZ
85044-1627
US

IV. Provider business mailing address

4747 E ELLIOT RD STE 29
PHOENIX AZ
85044-1629
US

V. Phone/Fax

Practice location:
  • Phone: 480-447-6696
  • Fax:
Mailing address:
  • Phone: 480-447-6696
  • Fax: 480-956-0944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number306860
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: