Individual provider Active NPI

Kaysha Richards, PSY.D.

  • Clinical Psychologist
  • Peoria, AZ
National Provider Identifier
1780050476
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4640 Issued in AZ
Practice address
14050 N 83Rd Ave Ste 290
Peoria, AZ 85381-5650
Phone
(623) 335-4504
Fax
(855) 811-0596
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4640 AZ Primary

Addresses

Primary practice location

14050 N 83Rd Ave Ste 290
Peoria, AZ 85381-5650

Mailing address

14050 N 83Rd Ave Ste 290
Peoria, AZ 85381-5650
Phone (623) 335-4504

Other practice location 1

7373 E Doubletree Ranch Rd
Ste. B-165
Scottsdale, AZ 85258-2035
Phone (623) 202-3639

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

LicenseStateTypeSpecialty
4640AZMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1780050476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815650",
            "telephone_number": "623-335-4504",
            "fax_number": "855-811-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815650",
            "telephone_number": "623-335-4504",
            "fax_number": "855-811-0596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7373 E Doubletree Ranch Rd",
            "address_2": "Ste. B-165",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852582035",
            "country_code": "US",
            "telephone_number": "623-202-3639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KAYSHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.