Individual provider Active NPI

Paula Eldridge

  • Cognitive & Behavioral Psychologist
  • Avondale, AZ
National Provider Identifier
1487834677
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
1252 S Avondale Blvd
Avondale, AZ 85323-8900
Phone
(623) 478-6080
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X MA Primary

Addresses

Primary practice location

1252 S Avondale Blvd
Avondale, AZ 85323-8900

Mailing address

1252 S Avondale Blvd
Avondale, AZ 85323-8900
Phone (623) 478-6080

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

LicenseStateTypeSpecialty
034042891MAMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1487834677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 S AVONDALE BLVD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238900",
            "telephone_number": "623-478-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 S AVONDALE BLVD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238900",
            "telephone_number": "623-478-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "PAULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.