Provider Demographics
NPI:1255157772
Name:MAGSANO, VERELYNN-GAY ASUNCION (PMHNP)
Entity type:Individual
Prefix:
First Name:VERELYNN-GAY
Middle Name:ASUNCION
Last Name:MAGSANO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 W COMBS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-9106
Mailing Address - Country:US
Mailing Address - Phone:480-299-7873
Mailing Address - Fax:
Practice Address - Street 1:85 W COMBS RD STE 101-277
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-9126
Practice Address - Country:US
Practice Address - Phone:480-299-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ315615363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty