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General NPI Number Information
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NPI Number | 1023620473
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Entity Type | Individual
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Provider Name | JESUS PRADO DNP, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 2120 W GUADALUPE RD STE 6
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City | MESA
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State | AZ
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Zip | 85202-7366
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Country | US
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Telephone | 602-230-7373
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Fax | 480-629-8577
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Provider Business Mailing Address
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Address Line | 3101 N CENTRAL AVE STE 550
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City | PHOENIX
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State | AZ
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Zip | 85012-2635
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Country | US
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Telephone | 602-230-7373
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Fax | 602-682-7455
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP285410
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RNP285410
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN210286
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License Number State | AZ
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