Organization Active NPI

Desert Canyon Psychiatry

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1770317422
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DESERT CANYON PSYCHIATRY
Practice address
11011 S 48TH St Ste 101
Phoenix, AZ 85044-1787
Phone
(602) 730-9670
Fax
(480) 864-9440
NPI assigned
Aug 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Venessa Joan Thompson, WHNP, PMHNPNPI 1801809702
Title
Nurse Practitioner, Owner
Phone
(602) 349-9546

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

11011 S 48TH St Ste 101
Phoenix, AZ 85044-1787

Mailing address

5560 W Geronimo St
Chandler, AZ 85226-4448
Phone (602) 349-9546

Other names 1

  • Desert Canyon Psychiatry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1770317422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 W GERONIMO ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264448",
            "telephone_number": "602-349-9546",
            "fax_number": "480-864-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 S 48TH ST STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850441787",
            "telephone_number": "602-730-9670",
            "fax_number": "480-864-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT CANYON PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "VENESSA",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "602-349-9546",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "WHNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Canyon Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desert Canyon Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.