Provider Demographics
NPI:1295519064
Name:OSENA HEALTH CONNECT
Entity type:Organization
Organization Name:OSENA HEALTH CONNECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:CLYDE
Authorized Official - Last Name:OSENA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:559-765-7755
Mailing Address - Street 1:5939 E PHELPS RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-9224
Mailing Address - Country:US
Mailing Address - Phone:559-765-7755
Mailing Address - Fax:559-354-5902
Practice Address - Street 1:5939 E PHELPS RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-9224
Practice Address - Country:US
Practice Address - Phone:559-765-7755
Practice Address - Fax:559-354-5902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1386979227Medicaid
CA1639641129Medicaid