Individual provider Active NPI

David Ralph Engstrom, PH.D.

  • Cognitive & Behavioral Psychologist
  • Scottsdale, AZ
National Provider Identifier
1194850248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
2048 Issued in AZ
Practice address
9832 N Hayden Rd
Suite 106
Scottsdale, AZ 85258-1298
Phone
(480) 443-3332
Fax
(480) 922-5569
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 2048 AZ Primary

Addresses

Primary practice location

9832 N Hayden Rd
Suite 106
Scottsdale, AZ 85258-1298

Mailing address

10059 E Cinnabar Ave
Scottsdale, AZ 85258-4802
Phone (480) 443-3332

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2048AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194850248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10059 E CINNABAR AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584802",
            "telephone_number": "480-443-3332",
            "fax_number": "480-922-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9832 N HAYDEN RD",
            "address_2": "SUITE 106",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852581298",
            "telephone_number": "480-443-3332",
            "fax_number": "480-922-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGSTROM",
        "first_name": "DAVID",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AZ",
            "license": "2048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • 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.