TINA MARIE GORDON NPI 1053021733

NPI Information

NPI: 1053021733
Provider Name: TINA MARIE GORDON
Classification: Adult Companion - 372600000X
Entity Type: Individual
Address:
4657 E ODESSA DR
QUEEN CREEK, AZ
ZIP 85140
Phone: (951) 305-1462
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Tina Marie Gordon is an adult companion in Queen Creek, AZ. The provider is an individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. Tina Marie Gordon NPI is 1053021733. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4657 E ODESSA DR
QUEEN CREEK, AZ
ZIP 85140-516
Phone: (951) 305-1462

The enumeration date for this NPI number is 12/2/2022 and was last updated on 12/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	253Z00000X	In Home Supportive Care				No
2	372600000X	Adult Companion				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	88-07544070	OTHER	ARIZONA	IN HOME CARE FOR ELDERLY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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