Provider Demographics
NPI:1336983840
Name:HAYASHI, JULIANE (MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:JULIANE
Middle Name:
Last Name:HAYASHI
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:JULIANE
Other - Middle Name:
Other - Last Name:FIDAZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7301 N 16TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5266
Mailing Address - Country:US
Mailing Address - Phone:602-510-2345
Mailing Address - Fax:623-321-6050
Practice Address - Street 1:7301 N 16TH ST STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5266
Practice Address - Country:US
Practice Address - Phone:623-233-0914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ309275363LP0808X
COC-APN.0103669-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health