Cynthia Deann Pence, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY005033 Issued in AZ

Practice address

635 E Baseline Rd
Phoenix, AZ 85042-6551

Phone

(602) 243-7277

Fax

(602) 243-1235

NPI assigned

Feb 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1538528906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W NORTH AVE",
            "address_2": "STE 303-A",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601422",
            "telephone_number": "877-807-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277",
            "fax_number": "602-243-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCE",
        "first_name": "CYNTHIA",
        "middle_name": "DEANN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009253",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY005033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447808",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara R. Pena, M.D.
• Thomas Robert Pena, D.O.
• Ashritha Penagaluri, M.D.,
• Irlena Alejandra Penaloza
• Cara E Pencak
• Erika Pence, DO
• Heidi Pence, APRN
• Randall A Pence, PA-C
• Ashley Christine Pendleton, ND
• Shanetta Pendlton-Davis

• Clinical Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.