NPIMap

Organization Active NPI

Joseph S. Vizzard, PH.D., P.S,

  • Psychologist
  • Edmonds, WA
National Provider Identifier
1053511360
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY0001307 Issued in WA
Legal business name
JOSEPH S. VIZZARD, PH.D., P.S,
Practice address
8311 212TH St SW
Edmonds, WA 98026-7443
Phone
(425) 771-8011
Fax
(425) 771-8009
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joseh Stephen Vizzard, PH.D
Title
.President/Psychologist
Phone
(425) 771-8011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY0001307 WA Primary

Addresses

Primary practice location

8311 212TH St SW
Edmonds, WA 98026-7443

Mailing address

8311 212TH St SW
Edmonds, WA 98026-7443
Phone (425) 771-8011

Other identifiers 3

IdentifierTypeStateIssuer
VI9735OtherWAREGENCE INSURANCE
7115884MedicaidWA
37852OtherWADEPARTMENT OF LABOR & INDUSTRIES

National Provider Directory

National Provider Directory

Locations

51 W Dayton St
Ste 102
Edmonds, WA 98020
Phone (206) 939-0476

7631 212th St SW
#108C
Edmonds, WA 98026
Phone (425) 771-8011

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1053511360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 212TH ST SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267443",
            "telephone_number": "425-771-8011",
            "fax_number": "425-771-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 212TH ST SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267443",
            "telephone_number": "425-771-8011",
            "fax_number": "425-771-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH S. VIZZARD, PH.D., P.S,",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "VIZZARD",
        "authorized_official_first_name": "JOSEH",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": ".PRESIDENT/PSYCHOLOGIST",
        "authorized_official_telephone_number": "425-771-8011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY0001307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE INSURANCE",
            "identifier": "VI9735",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7115884",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR & INDUSTRIES",
            "identifier": "37852",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.