Healthcare Provider Details

I. General information

NPI: 1982913034
Provider Name (Legal Business Name): JANETTE MARISA ALBARRACIN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2010
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N CENTRAL AVE
PHOENIX AZ
85004-1722
US

IV. Provider business mailing address

252 CLARK AVE
ROCHESTER NY
14609-1145
US

V. Phone/Fax

Practice location:
  • Phone: 866-633-3700
  • Fax:
Mailing address:
  • Phone: 917-334-0758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP3802
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: