NPIMap

Organization Active NPI

Pamela S Klonoff PHD PLLC

  • Clinical Neuropsychologist
  • Phoenix, AZ
National Provider Identifier
1336112093
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1239 Issued in AZ
Legal business name
PAMELA S KLONOFF PHD PLLC
Practice address
222 W Thomas Rd
Suite 401
Phoenix, AZ 85013-4419
Phone
(602) 406-3473
NPI assigned
Feb 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Dr. Pamela S Klonoff, PHD
Title
President
Phone
(602) 406-3473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 1239 AZ Primary

Addresses

Primary practice location

222 W Thomas Rd
Suite 401
Phoenix, AZ 85013-4419

Mailing address

PO Box 27340
Phoenix, AZ 85061-7340
Phone (602) 943-9200

Other identifiers 1

IdentifierTypeStateIssuer
731332MedicaidAZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1336112093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850617340",
            "telephone_number": "602-943-9200",
            "fax_number": "602-216-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W THOMAS RD",
            "address_2": "SUITE 401",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134419",
            "telephone_number": "602-406-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA S KLONOFF PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "KLONOFF",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-406-3473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "1239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "731332",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "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 Apr 7, 2011; 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.