Active NPI
Vanja Djurdjevic
- Psychologist
- Phoenix, AZ
National Provider Identifier
1558862649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4935
- Practice address
- 11221 N 28TH Dr BLDG E
Phoenix, AZ 85029-5615 - Phone
- (602) 997-2233
- NPI assigned
- Feb 23, 2018
- Last updated
- Feb 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4935 | AZ | Primary |
Addresses
Primary practice location
11221 N 28TH Dr BLDG E
Phoenix, AZ 85029-5615
Mailing address
21610 N 29TH Dr
Phoenix, AZ 85027-2354
Phone (623) 242-4119
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4935 | AZ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1558862649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21610 N 29TH DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850272354",
"telephone_number": "623-242-4119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11221 N 28TH DR BLDG E",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850295615",
"telephone_number": "602-997-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DJURDJEVIC",
"first_name": "VANJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-23",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "4935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
- Edwige Dea Djassa, FNP
- Constantine Stephen Djedjos, MD
- Cynthia Djengue, LCSW
- Djio Holdings Incorporated Dba Firstlight Home Care of Cave Creek, Az
- DJLW Health Services Inc. (Wheeler O&P)
- DK Advocates Inc.
- DK Advocates Inc.
- DM Estrella Pharmacy Inc (Estrella Pharmacy)
- DM Home Assessments LLC
- DME International Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.