Active NPI
Sandra K Douville, EDS
- School Psychologist
- Tucson, AZ
National Provider Identifier
1265196315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 6368456
- Practice address
- 9290 E Golf Links Rd
Tucson, AZ 85730-1305 - Phone
- (520) 428-3010
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 6368456 | AZ | Primary |
Addresses
Primary practice location
9290 E Golf Links Rd
Tucson, AZ 85730-1305
Mailing address
13697 E Shadow Pines LN
Vail, AZ 85641-6406
Phone (509) 230-4285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209507801 | Other | WA | SEIU CARE PROVIDER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6368456 | AZ | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1265196315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13697 E SHADOW PINES LN",
"city": "VAIL",
"state": "AZ",
"postal_code": "856416406",
"telephone_number": "509-230-4285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9290 E GOLF LINKS RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857301305",
"telephone_number": "520-428-3010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUVILLE",
"first_name": "SANDRA",
"middle_name": "K",
"credential": "EDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "AZ",
"license": "6368456",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SEIU CARE PROVIDER",
"identifier": "209507801",
"state": "WA"
}
],
"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 Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.