Provider Demographics
NPI:1407748080
Name:MASUNU-TOOTOO, VIVAMARIA
Entity type:Individual
Prefix:
First Name:VIVAMARIA
Middle Name:
Last Name:MASUNU-TOOTOO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 W APACHE TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-3733
Mailing Address - Country:US
Mailing Address - Phone:480-999-3323
Mailing Address - Fax:
Practice Address - Street 1:530 E CHRISTOPHER ST
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-5742
Practice Address - Country:US
Practice Address - Phone:480-776-4653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health