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General NPI Number Information
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NPI Number | 1033074273
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Entity Type | Organization
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Legal Business Name | JUPITER CANYON TELEHEALTH PLLC
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 6219 W ALTADENA AVE
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City | GLENDALE
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State | AZ
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Zip | 85304-3203
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Country | US
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Telephone | 623-745-1251
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Fax | 808-673-0171
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Provider Business Mailing Address
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Address Line | 5830 W THUNDERBIRD RD STE B8
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City | GLENDALE
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State | AZ
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Zip | 85306-4655
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Country | US
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Telephone | 623-745-1251
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Fax | 623-745-1251
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ASHLEY MCKENDALL
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Credential | NP
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Telephone | 623-745-1251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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