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General NPI Number Information
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NPI Number | 1023705225
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Entity Type | Organization
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Legal Business Name | VALLEY VISTA PSYCHIATRY PLLC
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 11155 DOLFIELD BLVD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3259
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Country | US
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Telephone | 480-853-1316
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Fax |
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Provider Business Mailing Address
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Address Line | 6245 E BELL RD STE 114
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6405
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Country | US
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Telephone | 480-803-5161
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JEAN N OGU
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Credential | PMHNP-BC
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Telephone | 480-803-5161
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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 |
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License Number State |
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