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General NPI Number Information
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NPI Number | 1740154012
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Entity Type | Individual
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Provider Name | JANICE VICENTE DNP, PMHNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 4688 W TANGERINE RD APT 19207
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City | MARANA
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State | AZ
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Zip | 85658-4907
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Country | US
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Telephone | 773-516-3868
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Fax |
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Provider Business Mailing Address
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Address Line | 4688 W TANGERINE RD APT 19207
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City | MARANA
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State | AZ
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Zip | 85658-4907
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Country | US
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Telephone |
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Fax | 520-200-0284
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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 | 321414
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License Number State | AZ
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