Provider Demographics
NPI:1720698814
Name:DOBBINS, JAYVEN SADAE (PA)
Entity type:Individual
Prefix:
First Name:JAYVEN
Middle Name:SADAE
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JAYVEN
Other - Middle Name:
Other - Last Name:HEILMAN-MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8675 S PRIEST DR STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1914
Mailing Address - Country:US
Mailing Address - Phone:480-739-0007
Mailing Address - Fax:480-779-6289
Practice Address - Street 1:8675 S PRIEST DR STE 102
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1914
Practice Address - Country:US
Practice Address - Phone:480-739-0007
Practice Address - Fax:480-779-6289
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant