MEDICARE: OASIS BLOOM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1306704903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS BLOOM LLC

Provider Business Mailing Address
First Line	:	4539 N 22ND ST STE 5407
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	623-688-2062
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST STE 5407
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	623-688-2062
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	CASSANDRA PIERCIN
Credential	:	PMHNP-BC
Telephone Number	:	623-688-2062

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “OASIS BLOOM LLC ” Practice Location

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