Individual provider Active NPI

Amy B Bjorkman, PHD

  • Psychologist
  • Scottsdale, AZ
National Provider Identifier
1104909308
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3797 Issued in AZ
Practice address
14300 N Northsight Blvd Ste 109
Scottsdale, AZ 85260-3673
Phone
(480) 688-4987
Fax
(480) 590-4982
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3797 AZ Primary

Addresses

Primary practice location

14300 N Northsight Blvd Ste 109
Scottsdale, AZ 85260-3673

Mailing address

14300 N Northsight Blvd Ste 109
Scottsdale, AZ 85260-3673
Phone (480) 688-4987

Other practice location 1

10229 N 92nd St
Suite 101
Scottsdale, AZ 85258-4562
Phone (480) 688-4987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 2, 2025 through Jan 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3797AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1104909308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 N NORTHSIGHT BLVD STE 109",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603673",
            "telephone_number": "480-688-4987",
            "fax_number": "480-590-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 N NORTHSIGHT BLVD STE 109",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603673",
            "telephone_number": "480-688-4987",
            "fax_number": "480-590-4982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10229 N 92nd St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852584562",
            "country_code": "US",
            "telephone_number": "480-688-4987",
            "fax_number": "480-657-0675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BJORKMAN",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.