David L Wodrich, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

445 Issued in AZ

Practice address

1919 E Thomas Rd
BLDG B
Phoenix, AZ 85016-7710

Phone

(602) 546-0486

Fax

(602) 546-1631

NPI assigned

Mar 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629037429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG C MANAGED CARE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-546-0486",
            "fax_number": "602-546-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-546-0486",
            "fax_number": "602-546-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODRICH",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730714",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karin Wittman, FP
• Mark A Wix, MD
• Lana E Wlodyka, MD
• Richard Wnuk, RT
• Masresha Hailu Wodajo
• John V Woellner, MD
• Charles Brent Woffinden, D.D.S.
• Scott John Woffinden, PA-C, PT
• James Wogan, LAC
• Kelsey Wogan, OTR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.