Georgia Yukiwma, P.H.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3073 Issued in AZ

Practice address

Hwy 264-Hopi Health Care Center
Second Mesa, AZ 86043-0068

Phone

(928) 737-6300

Fax

(928) 737-6333

NPI assigned

Dec 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Hopi Tribe-the Hopi Guidance Center

  • Community/Behavioral Health Agency
  • Second Mesa, AZ
  • NPI 1538238563
  Authorized official Same address or phone

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073678710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "KYKOTSMOVI",
            "state": "AZ",
            "postal_code": "860390002",
            "telephone_number": "928-737-6300",
            "fax_number": "928-737-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 264-HOPI HEALTH CARE CENTER",
            "city": "SECOND MESA",
            "state": "AZ",
            "postal_code": "860430068",
            "telephone_number": "928-737-6300",
            "fax_number": "928-737-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUKIWMA",
        "first_name": "GEORGIA",
        "name_prefix": "Dr.",
        "credential": "P.H.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "449282",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Hopi Tribe-the Hopi Guidance Center

• Clinical Psychologist in Second Mesa, AZ
• Providers in Second Mesa, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.