Individual provider Active NPI

Ryan Drzewiecki, PSYD, LP

  • Psychologist
  • Tucson, AZ
National Provider Identifier
1184178774
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4738 Issued in AZ
Practice address
39580 S Lago del Oro Pkwy
Tucson, AZ 85739-1091
Phone
(602) 334-9904
NPI assigned
Aug 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4738 AZ Primary

Addresses

Primary practice location

39580 S Lago del Oro Pkwy
Tucson, AZ 85739-1091

Mailing address

10384 N Fair Mountain Dr
Tucson, AZ 85737-9058
Phone (602) 334-9904

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4738AZMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1184178774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10384 N FAIR MOUNTAIN DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857379058",
            "telephone_number": "602-334-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39580 S LAGO DEL ORO PKWY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857391091",
            "telephone_number": "602-334-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRZEWIECKI",
        "first_name": "RYAN",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "4738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.