Provider Demographics
NPI:1699362251
Name:FRANK, JONATHAN (PMHNP)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:FRANK
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 1:739 E VISTA DEL CERRO DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6825
Mailing Address - Country:US
Mailing Address - Phone:480-235-4816
Mailing Address - Fax:
Practice Address - Street 1:104 E CAMELBACK AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016
Practice Address - Country:US
Practice Address - Phone:480-235-4816
Practice Address - Fax:855-458-0280
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN1724742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry