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General NPI Number Information
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NPI Number | 1972396026
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Entity Type | Organization
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Legal Business Name | HEALING HEARTS AZ
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1710 W RANCH RD STE 103
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City | TEMPE
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State | AZ
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Zip | 85284-2024
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Country | US
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Telephone | 602-428-4780
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 W RANCH RD STE 103
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City | TEMPE
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State | AZ
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Zip | 85284-2024
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Country | US
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Telephone | 602-428-4780
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Fax |
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Authorized Official
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Title or Position | PSYCH NP
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Name | DR. HERENDIRA SHAHNAZ SHAHNAZ
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Credential | DOCTOR OF NURSING
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Telephone | 602-428-3693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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