Provider Demographics
NPI:1447050539
Name:AZ MINDSET WELLNESS LLC
Entity type:Organization
Organization Name:AZ MINDSET WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-233-7051
Mailing Address - Street 1:706 W SOUTHERN AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-5000
Mailing Address - Country:US
Mailing Address - Phone:480-233-7051
Mailing Address - Fax:
Practice Address - Street 1:1736 S ROBIN LN
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7260
Practice Address - Country:US
Practice Address - Phone:480-233-7051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty