Active NPI
Krystina A. Gordon, PSY.D.
- Clinical Psychologist
- Scottsdale, AZ
National Provider Identifier
1750656369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4240
- Practice address
- 10752 N 89TH PL Ste 221
Scottsdale, AZ 85260-6745 - Phone
- (480) 463-4432
- NPI assigned
- Mar 14, 2012
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4240 | AZ | Primary |
Addresses
Primary practice location
10752 N 89TH PL Ste 221
Scottsdale, AZ 85260-6745
Mailing address
10752 N 89TH PL Ste 221
Scottsdale, AZ 85260-6745
Phone (480) 463-4432
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 |
|---|---|---|---|
| 4240 | AZ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382486400000",
"number": "1750656369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10752 N 89TH PL STE 221",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852606745",
"telephone_number": "480-463-4432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10752 N 89TH PL STE 221",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852606745",
"telephone_number": "480-463-4432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "KRYSTINA",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-14",
"last_updated": "2013-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "4240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.