Provider Demographics
NPI:1659990844
Name:MENJA, CHOLLETA WANJIRU (DNP-PMHNP)
Entity Type:Individual
Prefix:DR
First Name:CHOLLETA
Middle Name:WANJIRU
Last Name:MENJA
Suffix:
Gender:F
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 W CARTER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6227
Mailing Address - Country:US
Mailing Address - Phone:480-232-8260
Mailing Address - Fax:
Practice Address - Street 1:3255 W CARTER RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-6227
Practice Address - Country:US
Practice Address - Phone:480-232-8260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ298893363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health