Active NPI
Lydiane Pamboud
- Mental Illness Community Based Residential Treatment Facility
- Tucson, AZ
National Provider Identifier
1730041336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- ADBH20008
- Practice address
- 2048 S McConnell Dr
Tucson, AZ 85710-8088 - Phone
- (520) 257-9744
- NPI assigned
- Dec 2, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | ADBH20008 | AZ | |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | ADBH20008 | AZ | Primary |
Addresses
Primary practice location
2048 S McConnell Dr
Tucson, AZ 85710-8088
Mailing address
4000 N Central Ave Ste 100
Phoenix, AZ 85012-3520
Phone (602) 708-0240
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ADBH20008 | AZ | MD | Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764633600000",
"number": "1730041336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 N CENTRAL AVE STE 100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850123520",
"telephone_number": "602-708-0240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2048 S MCCONNELL DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857108088",
"telephone_number": "520-257-9744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAMBOUD",
"first_name": "LYDIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-02",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "AZ",
"license": "ADBH20008",
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "AZ",
"license": "ADBH20008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.