Healthcare Provider Details

I. General information

NPI: 1750262762
Provider Name (Legal Business Name): GAYRENE OCUAMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 E BASELINE RD STE 101
TEMPE AZ
85283-1533
US

IV. Provider business mailing address

647 W PRINCETON AVE
GILBERT AZ
85233-3225
US

V. Phone/Fax

Practice location:
  • Phone: 480-907-8304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number285612
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: