Basic Information
| Provider Information | |||||||||
| NPI: | 1710572227 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARVIZU | ||||||||
| FirstName: | OKSANA | ||||||||
| MiddleName: | ALICIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2421 S SAINT THOMAS AQUINAS DR | ||||||||
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| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857137419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202648855 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9015 N 3RD ST | ||||||||
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| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850202444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808824545 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2021 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 8706 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.