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General NPI Number Information
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NPI Number | 1730487802
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Entity Type | Individual
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Provider Name | TRICIA A. LATIOLAIT P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2011
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 10180 W HAPPY VALLEY PKWY STE 100
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City | PEORIA
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State | AZ
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Zip | 85383-1389
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Country | US
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Telephone | 623-227-4585
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Fax |
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Provider Business Mailing Address
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Address Line | 15845 W ARROWHEAD DR
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City | SURPRISE
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State | AZ
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Zip | 85374-5631
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Country | US
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Telephone | 562-307-3672
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 11137
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License Number State | AZ
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