Sunrise Psychiatry PLLC
Psychiatry & Neurology, Psychiatry in Mesa, AZ. Organization (NPI-2).
NPI number1790466035
StatusActive
Last updated in NPPESOct 16, 2025
Details
- NPI
- 1790466035
- Entity type
- Organization (NPI-2)
- Legal business name
- Sunrise Psychiatry PLLC
- Organization subpart
- No
- Enumeration date
- Jul 28, 2023
- Certification date
- Oct 16, 2025
- Last updated
- Oct 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 2084A0401X | Psychiatry & Neurology, Addiction Medicine | – | – | |
| 208D00000X | General Practice | – | – |
Practice location
1520 S Dobson Rd Ste 213aMesa, AZ 85202-4767
Phone 480-382-6982
Mailing address
1520 S Dobson Rd Ste 213aMesa, AZ 85202-4767
Authorized official
Tallan Depriest
Director
4803826982
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