Provider Demographics
NPI:1386273688
Name:CRESANTA, JASMINE (DNP-PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:
Last Name:CRESANTA
Suffix:
Gender:
Credentials:DNP-PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 S ALMA SCHOOL RD STE C204
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3043
Mailing Address - Country:US
Mailing Address - Phone:480-454-6370
Mailing Address - Fax:480-336-3080
Practice Address - Street 1:1930 S ALMA SCHOOL RD STE C204
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3043
Practice Address - Country:US
Practice Address - Phone:480-454-6370
Practice Address - Fax:480-336-3080
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ240165363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health