Healthcare Provider Details

I. General information

NPI: 1366154619
Provider Name (Legal Business Name): COSMAS OJARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16220 N SCOTTSDALE RD STE 300-1024
SCOTTSDALE AZ
85254-1781
US

IV. Provider business mailing address

16220 N SCOTTSDALE RD STE 300-1024
SCOTTSDALE AZ
85254-1781
US

V. Phone/Fax

Practice location:
  • Phone: 310-760-1977
  • Fax:
Mailing address:
  • Phone: 602-484-3448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: