MEDICARE: TITUS TJALAS FNP-BC, PMHNP-BC

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	815057	NV
2	363LF0000X	Family Nurse Practitioner	234051	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	607851	CA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	234051	AZ
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10028304	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	615761900	OTHER	AZ	DEEOIC HOME HEALTH CARE PROVIDER

General Provider Information

NPI Number	:	1487930871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TITUS TJALAS FNP-BC, PMHNP-BC

Provider Business Mailing Address
First Line	:	7620 N HARTMAN LN STE 180
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-7485
Country	:	US
Telephone Number	:	520-345-0443
Fax Number	:	866-531-9664

Provider Business Practice Location Address
First Line	:	7620 N HARTMAN LN STE 180
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-7485
Country	:	US
Telephone Number	:	520-689-6814
Fax Number	:	866-740-4777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2011
Last Update Date	:	04/09/2026

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Directions to “ TITUS TJALAS FNP-BC, PMHNP-BC” Practice Location

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