LICEETT PENA FNP-C
NPI 1740705961
Nurse Practitioner - Family in Mesa, AZ

Q: What is Liceett Pena's NPI number?

The NPI number for Liceett Pena is 1740705961. It was assigned to this individual provider in the NPPES registry on August 9, 2017.

Q: What is Liceett Pena's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Liceett Pena was last updated on September 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 09, 2017

616 E SOUTHERN AVE STE 103, MESA, AZ 85204(602) 569-3999(602) 569-3887 Get Directions Write a Review

NPPES record last updated: September 21, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 21, 2018, Aug 24, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

On this page

About Liceett Pena Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LICEETT PENA FNP-C (NPI 1740705961) is an individual family provider in Mesa, Arizona, licensed in Arizona (AP11544) and active in the NPI registry since August 2017. She maintains 5 additional practice locations.

NPPES Registry Identity

NPI1740705961

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLICEETT PENACredential: FNP-C

Location Address616 E SOUTHERN AVE STE 103Mesa, AZ 85204

Mailing Address1533 E Willetta StPhoenix, AZ 85006-2935 · (602) 569-3999 · Fax (602) 569-3887

Phone(602) 569-3999

Fax(602) 569-3887

Sole ProprietorNo

Enumeration DateAugust 9, 2017

Last NPPES UpdateSeptember 21, 20184 updates tracked since enumeration

✔ NPI 1740705961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · AP11544

Also ListedRegistered NurseTaxonomy 163W00000X · License RN182545 (AZ)

616 E SOUTHERN AVE STE 103, Mesa, AZ 85204

Open in Google Maps ↗

Secondary Practice Locations 5

Location 11315 W Southern AveTempe, AZ 85282-4519 · Phone (602) 569-3999 · Fax (602) 569-3887

Location 2301 E Cottonwood Ln Ste 12Casa Grande, AZ 85122-2551 · Phone (602) 569-3999 · Fax (602) 569-3887

Location 313402 N 32nd St Ste 5Phoenix, AZ 85032-6047 · Phone (602) 569-3999 · Fax (602) 569-3887

Location 47734 N 59th AveGlendale, AZ 85301-7816 · Phone (602) 569-3999 · Fax (602) 569-3887

Location 51533 E Willetta StPhoenix, AZ 85006-2935 · Phone (602) 569-3999 · Fax (602) 569-3887

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc..Insurance ›

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

22 services16 patients

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERICK TORRES FNP

Nurse Practitioner (Family)