Rebecca Siddiqui

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AL8880H Issued in AZ

Practice address

4113 W Hayward Ave
Phoenix, AZ 85051-5751

Phone

(623) 336-7568

Fax

(623) 399-8915

NPI assigned

Oct 28, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1346645702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 W MCRAE WAY",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085837",
            "telephone_number": "602-332-0780",
            "fax_number": "623-399-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 W HAYWARD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850515751",
            "telephone_number": "623-336-7568",
            "fax_number": "623-399-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "AL8880H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926240",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Sicora
• Gamal F Sidarous, MD
• Rajiv Siddaramu, MD
• Mehtab Fatima Siddiky, M.D
• Fatima Siddiqi, AGACNP
• Ryan Sidebottom, FNP
• Lawrence Mark Sideman, PH.D.
• Scot Michael Sidener, COTA L
• Jagdeep Sidhu, M.D.
• Jiten Sidhu, PHARM.D.

• Adult Care Home Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.