Jasa Defazio, COTA/L

Primary specialty

Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X

License

OTA-046588 Issued in AZ

Practice address

2175 N Alma School Rd Ste A106
Chandler, AZ 85224-2882

Phone

(480) 855-0474

NPI assigned

Jul 15, 2018

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531612800000",
    "number": "1740766567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7340 E LEGACY BLVD UNIT H4005",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852556531",
            "telephone_number": "484-400-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 N ALMA SCHOOL RD STE A106",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242882",
            "telephone_number": "480-855-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "JASA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2018-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "AZ",
            "license": "OTA-046588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "946932790",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Deane
• Jennifer Dechant, P.A.
• Janice Decker
• Erica Ann Dee
• Justin Deer, ATC
• Robert A. Defazio, D.C.
• Lois Degraffenreid
• Lexi Paige Degreef, COTA/L
• Matthew Deguzman
• Glenn R Deibert, MD

• Pediatric Neurodevelopmental Disabilities Physician in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Pediatric Neurodevelopmental Disabilities Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.