Active NPI
Cerebro Wellness
- Psychiatry Physician
- Tempe, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- CEREBRO WELLNESS
- Practice address
- 2111 E Baseline Rd Ste F4
Tempe, AZ 85283-1519 - Phone
- (602) 888-3474
- Fax
- (762) 212-4347
- NPI assigned
- Aug 11, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bryan Keoke Lazaro, PMHNP
- Title
- Owner
- Phone
- (602) 904-2277
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
2111 E Baseline Rd Ste F4
Tempe, AZ 85283-1519
Mailing address
5223 1/2 S 5TH St
Phoenix, AZ 85040-8707
Phone (602) 904-2277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3031 W Northern Ave
Ste 109
Phoenix, AZ 85051
Phone (602) 888-3474
2111 E Baseline Rd
Ste F4
Tempe, AZ 85283
Phone (480) 756-9455
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Phoenix, AZ
- NPI 1609639343
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Tempe, AZ
- NPI 1912458845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1699574400000",
"number": "1629689922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5223 1/2 S 5TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850408707",
"telephone_number": "602-904-2277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 E BASELINE RD STE F4",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852831519",
"telephone_number": "602-888-3474",
"fax_number": "762-212-4347"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CEREBRO WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-11",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A",
"authorized_official_last_name": "LAZARO",
"authorized_official_first_name": "BRYAN",
"authorized_official_middle_name": "KEOKE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "602-904-2277",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.