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General NPI Number Information
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NPI Number | 1003779950
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Entity Type | Individual
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Provider Name | ALEXIS KAMA NAKAYAMA
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Gender | Female
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 4100 S LINDSAY RD
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City | GILBERT
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State | AZ
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Zip | 85297-1506
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Country | US
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Telephone | 480-219-3953
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 E SAGITTARIUS PL
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City | CHANDLER
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State | AZ
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Zip | 85249-3753
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA-050220
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License Number State | AZ
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