Healthcare Provider Details

I. General information

NPI: 1770491771
Provider Name (Legal Business Name): GISSELLE OROZCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 E BASELINE RD STE 101
TEMPE AZ
85283-1508
US

IV. Provider business mailing address

PO BOX 2072
SOMERTON AZ
85350-2072
US

V. Phone/Fax

Practice location:
  • Phone: 480-902-0771
  • Fax:
Mailing address:
  • Phone: 323-535-4254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: