MEDICARE: HANA BOVA

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	101YM0800X	Mental Health Counselor		CA

General Provider Information

NPI Number	:	1710845516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANA BOVA

Provider Business Mailing Address
First Line	:	18188 N 59TH LN
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-1100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17235 N 75TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-0831
Country	:	US
Telephone Number	:	480-641-1165
Fax Number	:

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

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

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Directions to “ HANA BOVA ” Practice Location

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