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PRISCA AJONGHAGE

Psychiatric/Mental Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1831783679

Individual Registrant:
 PRISCA  AJONGHAGE 
Gender: F
Sole Proprietor

Location and contact information for practice:
17470 W VENTURA ST  SURPRISE, AZ 85388-7806 US
Tel: 408-597-5067  Fax: --

Contact information for business:
17470 W VENTURA ST  SURPRISE, AZ 85388-7806 US
Tel: --  Fax: --

Registration Information:
NPI: 1831783679
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LP0808XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Psychiatric/Mental Health
AZ254054

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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