Individual provider Active NPI

Yadira Verdugo

  • Assisted Living Facility (Behavioral Disturbances)
  • Tucson, AZ
National Provider Identifier
1801292206
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
License
999995224 Issued in AZ
Practice address
10915 S.Cherokee LN
Tucson, AZ 85736
Phone
(520) 240-7817
NPI assigned
Nov 12, 2014
Last updated
Nov 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X 999995224 AZ Primary

Addresses

Primary practice location

10915 S.Cherokee LN
Tucson, AZ 85736

Mailing address

PO Box 26322
Tucson, AZ 85726-6322
Phone (520) 240-7817

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
999995224AZMDAssisted Living Facility (Behavioral Disturbances)

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1801292206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26322",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857266322",
            "telephone_number": "520-240-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 S.CHEROKEE LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85736",
            "telephone_number": "520-240-7817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUGO",
        "first_name": "YADIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "AZ",
            "license": "999995224",
            "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 Nov 12, 2014; 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.