Healthcare Provider Details

I. General information

NPI: 1912840042
Provider Name (Legal Business Name): DANIELLE REMITIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W BASELINE RD STE 108
TEMPE AZ
85283-5349
US

IV. Provider business mailing address

13304 E BOSTON ST
CHANDLER AZ
85225-6103
US

V. Phone/Fax

Practice location:
  • Phone: 928-504-4700
  • Fax:
Mailing address:
  • Phone: 602-330-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number220884
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: