Healthcare Provider Details
I. General information
NPI: 1487562773
Provider Name (Legal Business Name): YUKA AL-MATTI LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US
IV. Provider business mailing address
4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US
V. Phone/Fax
- Phone: 623-920-0022
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YUKA
AL-MATTI
Title or Position: CEO
Credential:
Phone: 623-920-0022