Healthcare Provider Details

I. General information

NPI: 1245194836
Provider Name (Legal Business Name): TANIDA GOLDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4165 N CRAFTSMAN CT
SCOTTSDALE AZ
85251-3863
US

IV. Provider business mailing address

40631 W LITTLE DR
MARICOPA AZ
85138-9585
US

V. Phone/Fax

Practice location:
  • Phone: 520-660-1380
  • Fax:
Mailing address:
  • Phone: 520-660-1380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-50555
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: