Provider Demographics
NPI:1558719955
Name:CRUZ, SONJA JEAN WILSON (DO)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:JEAN WILSON
Last Name:CRUZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 W APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-3958
Mailing Address - Country:US
Mailing Address - Phone:480-870-7130
Mailing Address - Fax:480-906-2171
Practice Address - Street 1:725 W APACHE TRL
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3958
Practice Address - Country:US
Practice Address - Phone:480-870-7130
Practice Address - Fax:480-906-2171
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine