Individual provider Active NPI

Yvette I Haughton

  • Child Mental Illness Respite Care
  • Peoria, AZ
National Provider Identifier
1114539004
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
6371616 Issued in AZ
Practice address
11275 N 99TH Ave Lot 117
Peoria, AZ 85345-5479
Phone
(623) 687-8031
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 6371616 AZ Primary

Addresses

Primary practice location

11275 N 99TH Ave Lot 117
Peoria, AZ 85345-5479

Mailing address

11275 N 99TH Ave
Peoria, AZ 85345-5471

Other identifiers 1

IdentifierTypeStateIssuer
6371616OtherAZTHERAPEUTIC/PROFESSIONAL FOSTER HOME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6371616AZMDChild Mental Illness Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1114539004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11275 N 99TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11275 N 99TH AVE LOT 117",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455479",
            "telephone_number": "623-687-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHTON",
        "first_name": "YVETTE",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "6371616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPEUTIC/PROFESSIONAL FOSTER HOME",
            "identifier": "6371616",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.