NPIMap

Organization Active NPI

Shelley S Kaufman PC

  • Psychologist
  • Glendale, AZ
National Provider Identifier
1831541069
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1389 Issued in AZ
Legal business name
SHELLEY S KAUFMAN PC
Practice address
17505 N 79TH Ave
Suite 315
Glendale, AZ 85308-8725
Phone
(602) 257-0560
NPI assigned
Jul 12, 2016
Last updated
Nov 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
Dr. Shelley Kaufman, PH.D.NPI 1740248376
Title
President
Phone
(602) 257-0560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 1389 AZ Primary

Addresses

Primary practice location

17505 N 79TH Ave
Suite 315
Glendale, AZ 85308-8725

Mailing address

PO Box 10863
Glendale, AZ 85318-0863
Phone (602) 257-0560

National Provider Directory

National Provider Directory

Locations

17505 N 79th Ave
Ste 115
Glendale, AZ 85308
Phone (302) 257-0560

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1831541069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10863",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853180863",
            "telephone_number": "602-257-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE",
            "address_2": "SUITE 315",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088725",
            "telephone_number": "602-257-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLEY S KAUFMAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-257-0560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "1389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.