San Tan Psychiatry PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SAN TAN PSYCHIATRY PLLC

Doing business as

San

Practice address

1910 S Stapley Dr Ste 217
Mesa, AZ 85204-6679

Phone

(602) 888-0370

Fax

(480) 748-4095

NPI assigned

Sep 11, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Mason, DMSC, PA-C

Title

Owner

Phone

(602) 888-0370

Specialties & licenses 2

Addresses

Other names 2

• San Doing business as
• San Tan Psychiatry Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kay Lynn Southwell, PMHNP-BC,NPC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1730320623
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1437936655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 217",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "602-888-0370",
            "fax_number": "480-748-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 217",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "602-888-0370",
            "fax_number": "480-748-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN TAN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-888-0370",
        "authorized_official_credential": "DMSC, PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Tan Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Tan Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Tan Psychiatry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Delaney Samuelson
• San Tan Behavioral Health SVCS
• San Tan Cardiovascular Center LLC
• San Tan Internal Medicine, PLLC
• San Tan Mobile Diagnostics LLC
• Sana Physical Therapy, LLC
• Amelia Joy Sanborn, RN
• Edna M. Sanches Goncalvez
• Katie Shandel Sanchez Amaya
• Lismerick L Sanchez Chacon

• Mental Health Clinic/Center (Including Community Mental Health Center) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.