Pedregosa-Dy Holistic Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PEDREGOSA-DY HOLISTIC WELLNESS LLC

Practice address

7301 N 16TH St Ste 102
Phoenix, AZ 85020-5266

Phone

(480) 280-8690

NPI assigned

Nov 15, 2021

Organization subpart

No

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

Authorized official

Name

Ian DyNPI 1780288852

Title

Nurse Practitioner

Phone

(480) 280-8690

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

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

• Ian Pedregosa Dy

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1780288852
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1831855683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 N 16TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205266",
            "telephone_number": "480-280-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 N 16TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205266",
            "telephone_number": "480-280-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDREGOSA-DY HOLISTIC WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "DY",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "480-280-8690"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Phoenix",
            "affiliation": "N",
            "address_1": "815 E Rose Ln Unit 117",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850141915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pedroso Psychological Services, LLC
• Pedroso Psychological Services, LLC
• Daniella De Marchiori Pedroso
• Juan Manuel Pedroza Reys, LBSW
• Christopher Peebles

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.