Provider Demographics
NPI:1437575388
Name:NAVARRO, LISA PACE (PMHNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:PACE
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MICHELLE
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:2730 S VAL VISTA DR STE 152
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1682
Mailing Address - Country:US
Mailing Address - Phone:480-471-8560
Mailing Address - Fax:888-979-8197
Practice Address - Street 1:2730 S VAL VISTA DR STE 146
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1679
Practice Address - Country:US
Practice Address - Phone:480-471-8560
Practice Address - Fax:888-979-8197
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5397363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily