RL Bonfiglio PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3756 Issued in AZ

Legal business name

RL BONFIGLIO PC

Practice address

7220 N 16TH St
Suite G
Phoenix, AZ 85020-5253

Phone

(602) 944-0480

Fax

(602) 944-1078

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Roxanne Bonfiglio, PSY.D.

Title

President

Phone

(602) 944-0480

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Roxanne Bonfiglio PsyD PC Doing business as

Locations

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407901523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 N 16TH ST",
            "address_2": "SUITE G",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205253",
            "telephone_number": "602-944-0480",
            "fax_number": "602-944-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 N 16TH ST",
            "address_2": "SUITE G",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205253",
            "telephone_number": "602-944-0480",
            "fax_number": "602-944-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RL BONFIGLIO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BONFIGLIO",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-944-0480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164405",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roxanne Bonfiglio PsyD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.