NPIMap

Organization Active NPI

Pedroso Psychological Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1235785395
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PEDROSO PSYCHOLOGICAL SERVICES, LLC
Practice address
11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039
Phone
(480) 310-8090
NPI assigned
Aug 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

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

Authorized official

Name
Dr. Daniella Pedroso, PSY.D.NPI 1215591623
Title
Owner
Phone
(480) 310-8090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039

Mailing address

11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039
Phone (480) 310-8090

Other identifiers 1

IdentifierTypeStateIssuer
1215591623MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drpedroso@therapysecure.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Pedroso Psychological Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675555200000",
    "number": "1235785395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 N TATUM BLVD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286039",
            "telephone_number": "480-310-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 N TATUM BLVD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286039",
            "telephone_number": "480-310-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDROSO PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A",
        "authorized_official_last_name": "PEDROSO",
        "authorized_official_first_name": "DANIELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-310-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215591623",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drpedroso@therapysecure.com",
            "affiliation": "N",
            "endpointDescription": "secure email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11011 S 48th St Ste 200",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850441788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; 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.