NPIMap

Organization Active NPI

San Pedro Health

  • Community/Behavioral Health Agency
  • Sierra Vista, AZ
National Provider Identifier
1841636776
Registry record updated May 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LAMFT-10301 Issued in AZ
Legal business name
SAN PEDRO HEALTH
Practice address
4151 La Linda Way Ste 102
Sierra Vista, AZ 85635-4600
Phone
(520) 515-9610
NPI assigned
May 19, 2013
Last updated
May 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2013

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

Authorized official

Name
Brooke Mansour
Title
Therapist
Phone
(520) 515-9610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LAMFT-10301 AZ Primary

Addresses

Primary practice location

4151 La Linda Way Ste 102
Sierra Vista, AZ 85635-4600

Mailing address

4151 La Linda Way Ste 102
Sierra Vista, AZ 85635-4600
Phone (520) 515-9610

National Provider Directory

National Provider Directory

Locations

4151 La Linda Way
Ste 102
Sierra Vista, AZ 85635
Phone (520) 515-9610

Practitioners & affiliated clinicians

Practitioners 8

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": "1368921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368921600000",
    "number": "1841636776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 LA LINDA WAY STE 102",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354600",
            "telephone_number": "520-515-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 LA LINDA WAY STE 102",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354600",
            "telephone_number": "520-515-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PEDRO HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-19",
        "last_updated": "2013-05-19",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "520-515-9610"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "LAMFT-10301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2013; 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.