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General NPI Number Information
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NPI Number | 1306198429
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Entity Type | Individual
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Provider Name | RANDY V. MALLARI PMHNP-BC, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 10250 N 124TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5201
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Country | US
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Telephone | 480-400-0850
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Fax | 602-860-6050
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Provider Business Mailing Address
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Address Line | 10250 N 124TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5201
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Country | US
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Telephone | 602-908-8580
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Fax | 480-590-6113
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034292
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-5050
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 83016
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 873430
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10041249
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 321587
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License Number State | AZ
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