Provider Demographics
NPI:1225375868
Name:BERONJA, SANYA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SANYA
Middle Name:
Last Name:BERONJA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 W REMUDA DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-7304
Mailing Address - Country:US
Mailing Address - Phone:602-478-6951
Mailing Address - Fax:
Practice Address - Street 1:1635 N GREENFIELD RD
Practice Address - Street 2:SUITE 134
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4005
Practice Address - Country:US
Practice Address - Phone:480-854-7123
Practice Address - Fax:480-854-7627
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily