Prestige Psychiatric Professionals, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP5217 Issued in AZ

Legal business name

PRESTIGE PSYCHIATRIC PROFESSIONALS, LLC

Doing business as

Prestige Psychiatric Professionals

Practice address

8414 E Shea Blvd
Suite 102
Scottsdale, AZ 85260-6665

Phone

(602) 910-6519

Fax

(602) 910-6519

NPI assigned

Apr 5, 2017

Last updated

Apr 5, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Paul Eric Larralde, PMHNP-BCNPI 1033546072

Title

Member

Phone

(602) 910-6519

Specialties & licenses 4

Addresses

Other names 1

• Prestige Psychiatric Professionals Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Eric Larralde, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1033546072
  Authorized official Same address or phone

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1437682614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 W CAREFREE HWY",
            "address_2": "STE 1-602",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850863201",
            "telephone_number": "602-910-6519",
            "fax_number": "602-910-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 E SHEA BLVD",
            "address_2": "SUITE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606665",
            "telephone_number": "602-910-6519",
            "fax_number": "602-910-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PSYCHIATRIC PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "LARRALDE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-910-6519",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11647",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-11774",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN147893",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP5217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Psychiatric Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.