Provider Demographics
NPI:1720065113
Name:YOZSA, SERRINA MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:SERRINA
Middle Name:MARIE
Last Name:YOZSA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:SERRINA
Other - Middle Name:MARIE
Other - Last Name:YOZSA-JEMMETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:3501 N SCOTTSDALE RD STE 246
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5630
Mailing Address - Country:US
Mailing Address - Phone:480-994-3668
Mailing Address - Fax:480-663-8110
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 246
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5630
Practice Address - Country:US
Practice Address - Phone:480-994-3668
Practice Address - Fax:480-663-8110
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0514213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ477233Medicaid
AZ78698OtherMEDICARE GROUP PIN
AZ2Z0160OtherHEALTHNET PIN
AZ7167058OtherAETNA PIN
AZ602490600OtherDEPT OF LABOR
AZAZ0195150OtherBCBSAZ PIN
AZAZ0195150OtherBCBSAZ PIN
AZ602490600OtherDEPT OF LABOR
AZ2Z0160OtherHEALTHNET PIN