Healthcare Provider Details

I. General information

NPI: 1396764361
Provider Name (Legal Business Name): JOHN STANLEY JACHNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S 6TH AVE TUCSON VAMC 4-116A
TUCSON AZ
85723-0001
US

IV. Provider business mailing address

3601 S 6TH AVE TUCSON VAMC 4-116A
TUCSON AZ
85723-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-1450
  • Fax: 520-629-4632
Mailing address:
  • Phone: 520-792-1450
  • Fax: 520-629-4632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number21755
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number21755
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: