Provider Demographics
NPI:1427675222
Name:OHARA, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:OHARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11221 N 28TH DR BLDG E
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-5615
Mailing Address - Country:US
Mailing Address - Phone:602-997-2233
Mailing Address - Fax:
Practice Address - Street 1:11221 N 28TH DR BLDG N28TH
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-5615
Practice Address - Country:US
Practice Address - Phone:602-997-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261420363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health