GREGORY TARAZON (NPI# 1639243512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639243512 |
| Entity Type | Individual |
| Full Name | GREGORY TARAZON |
| Other Name | CONNIE TARAZON |
| Practice Address |
2019 W Vineyard Plains Dr Queen Creek AZ 85242-6378 |
| Practice Telephone | 4806555286 |
| Mailing Telephone | 4806555286 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
10045 | AZ | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS | 965840 | 01 |
| Street Address |
2019 W VINEYARD PLAINS DR |
| City | QUEEN CREEK |
| State | AZ |
| Zip Code | 85242-6378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932430618 | Di Nguyen | Pharmacist | 3111 West Hunt Highway, Queen Creek, AZ 85242 | 2010-01-20 |
| 1174857056 | Jessica Lynn Donnelly | Behavioral Analyst | 21007 E. Avendia Del Valle, Queen Creek, AZ 85242 | 2009-09-25 |
| 1306093984 | Charles Mckenzie | Dentist | 40815 N Ironwood Drive, Ste A102, Queen Creek, AZ 85242 | 2008-08-26 |
| 1104014943 | Queen Creek Smiles, LLP | Dentist | 18550 East Rittenhouse Road, Suite 103, Queen Creek, AZ 85242 | 2007-10-05 |
| 1972700359 | Sunrise Internal Medicine PC | Internal Medicine | 22707 S. Ellsworth Rd., Suite #h105, Queen Creek, AZ 85242 | 2007-06-29 |
| 1083811277 | Brian Joseph Goodman | Dentist | 18610 E. Rittenhouse Rd., Queen Creek, AZ 85242 | 2007-06-29 |
| 1972704757 | San Tan Urgent Care Health Center | Clinic/Center | 21321 E Ocotillo Road, Suite 118, Queen Creek, AZ 85242 | 2007-05-30 |
| 1538375647 | Jennifer Jean Job | Occupational Therapy Assistant | 3575 E Lawndale Place, Queen Creek, AZ 85242 | 2007-05-15 |
| 1972718823 | Eric Joseph Harris | Dentist | 20261 E. Ocotillo Road, Suite 120, Queen Creek, AZ 85242 | 2007-05-14 |
| 1477767010 | San Tam Dental Care & Mobile Clinic PC | Dentist | 22240 S Ellsworth Rd, Suite 102, Queen Creek, AZ 85242 | 2007-05-10 |
| Find all providers in zip 85242 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972163293 | Harold Kilgore | Respite Care | 3734 E Longhorn St, Queen Creek, AZ 85140-4303 | 2019-06-18 |
| 1932567229 | Adriana Ratzlaff | Respite Care | 20820 E Pickett St, Queen Creek, AZ 85142-9533 | 2016-02-02 |
| 1073748463 | Noel I Vandyke | Respite Care | 3542 E Amarillo Way, Queen Creek, AZ 85240-4320 | 2009-05-28 |
| 1700038262 | Lonnie L Bellamy | Respite Care | 18611 E Swan Dr, Queen Creek, AZ 85242-5148 | 2008-10-15 |
| 1548326085 | Todd Kemmerer | Respite Care | 861 E Chelsea Dr, Queen Creek, AZ 85242-5658 | 2006-12-29 |
| 1407912298 | Jeffrey J. Hamilton | Respite Care | 2712 W Gold Dust Ave, Queen Creek, AZ 85242-6725 | 2006-12-28 |
| 1396801957 | Stanley Jamar Pruitt | Respite Care | 35510 N Belgian Blue Ct, Queen Creek, AZ 85243-5518 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539004 | Yvette I Haughton | Respite Care | 11275 N 99th Ave Lot 117, Peoria, AZ 85345-5479 | 2020-08-20 |
| 1700411576 | Jaquelina Andrea Reyes | Respite Care | 25279 W Centre Ave, Buckeye, AZ 85326-2468 | 2020-03-11 |
| 1740815497 | Jerome Alexander-terrell Jackson | Respite Care | 9680 W Northern Ave Unit 2311, Peoria, AZ 85345-4655 | 2020-03-03 |
| 1912539941 | Elizabeth Ann Mannel | Respite Care | 1225 W Panorama Rd, Tucson, AZ 85704-2834 | 2020-02-07 |
| 1093345498 | New Hope of Arizona, Inc. | Respite Care | 12545 W Woodland Ave, Avondale, AZ 85323-8025 | 2020-01-24 |
| 1033757877 | Jessica Annette Dixon-tatum | Respite Care | 401 N 6th St, Buckeye, AZ 85326-2415 | 2019-12-11 |
| 1700423902 | Randy Bland | Respite Care | 20731 W Stone Hill Road, Buckeye, AZ 85396 | 2019-12-06 |
| 1003459934 | Stephanie Denise Jackson | Respite Care | 22321 W Morning Glory St, Buckeye, AZ 85326-7181 | 2019-10-23 |
| 1285276345 | Charlyn Ponds | Respite Care | 235 E Ray Rd Apt 2035, Chandler, AZ 85225-3362 | 2019-10-10 |
| 1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
| Find all providers with the same taxonomy | ||||
| City | QUEEN CREEK |
| Zip Code | 85242 |
Please comment or provide details below to improve the information on GREGORY TARAZON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.