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General NPI Number Information
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NPI Number | 1285590760
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Entity Type | Individual
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Provider Name | DONNETRA D SASARAKU
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1541 W CORONA DR
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City | CHANDLER
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State | AZ
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Zip | 85224-8557
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Country | US
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Telephone | 602-767-9752
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Fax |
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Provider Business Mailing Address
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Address Line | 1541 W CORONA DR UNIT 1148
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City | CHANDLER
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State | AZ
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Zip | 85224-8557
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Country | US
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Telephone | 602-767-9752
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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 | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | AL12534H
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License Number State | AZ
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