Individual
GINNO DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1500 N PRIEST DR # 109, TEMPE, AZ 85288-1213
(702) 589-4871
Mailing address
14894 W VALENTINE ST, SURPRISE, AZ 85379-4277
(480) 278-5842
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
314334
AZ
Other
Enumeration date
09/17/2024
Last updated
07/24/2025
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