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NPI 1346071966

NPI 1346071966 : TITILAYO RAJI : SAN TAN VLY, AZ

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General NPI Number Information
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    NPI Number           |    1346071966
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    Entity Type          |    Individual 
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    Provider Name        |    TITILAYO RAJI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/13/2024
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    Last Update Date     |    12/11/2025
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Provider Practice Location Address
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    Address Line         |    3691 W GOLDMINE MOUNTAIN DR 
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    City                 |    SAN TAN VLY
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    State                |    AZ
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    Zip                  |    85144-6592
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    Country              |    US
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    Telephone            |    602-707-6582
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3691 W GOLDMINE MOUNTAIN DR 
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    City                 |    SAN TAN VALLEY
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    State                |    AZ
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    Zip                  |    85144-6592
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    Country              |    US
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    Telephone            |    602-707-6582
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    313398
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    License Number State |    AZ
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