Provider Demographics
NPI:1629720503
Name:NAVARRO, SERGIO (PMHNP)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 S VAL VISTA DR STE 146
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1679
Mailing Address - Country:US
Mailing Address - Phone:480-542-0202
Mailing Address - Fax:
Practice Address - Street 1:2730 S VAL VISTA DR STE 146
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1679
Practice Address - Country:US
Practice Address - Phone:480-542-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-22
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTEMP2689172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry