Active NPI
Elisa M Maldonado, MA
- School Psychologist
- Mesa, AZ
National Provider Identifier
1710017330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 299218
- Practice address
- 9430 E Neville Ave
Mesa, AZ 85209-1500 - Phone
- (480) 635-2011
- Fax
- (480) 635-2020
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 299218 | NM | Primary |
Addresses
Primary practice location
9430 E Neville Ave
Mesa, AZ 85209-1500
Mailing address
9430 E Neville Ave
Mesa, AZ 85209-1500
Phone (480) 635-2011
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 299218 | NM | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249344000000",
"number": "1710017330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9430 E NEVILLE AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852091500",
"telephone_number": "480-635-2011",
"fax_number": "480-635-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9430 E NEVILLE AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852091500",
"telephone_number": "480-635-2011",
"fax_number": "480-635-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "ELISA",
"middle_name": "M",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2009-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NM",
"license": "299218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.