Active NPI
Pedroso Psychological Services, LLC
- Clinical Psychologist
- Phoenix, AZ
National Provider Identifier
1871136150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- PEDROSO PSYCHOLOGICAL SERVICES, LLC
- Practice address
- 11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039 - Phone
- (480) 310-8090
- NPI assigned
- Oct 19, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Daniella Pedroso, PSY.D.
- Title
- Owner
- Phone
- (480) 310-8090
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039
Mailing address
11201 N Tatum Blvd Ste 300
Phoenix, AZ 85028-6039
Phone (480) 310-8090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215591623 | Medicaid | AZ |
National Provider Directory
National Provider Directory- Tax ID family
- Pedroso Psychological Services LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Phoenix, AZ
- NPI 1235785395
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- Phoenix, AZ
- NPI 1215591623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571443200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675555200000",
"number": "1871136150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11201 N TATUM BLVD STE 300",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286039",
"telephone_number": "480-310-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 N TATUM BLVD STE 300",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286039",
"telephone_number": "480-310-8090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDROSO PSYCHOLOGICAL SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-19",
"last_updated": "2023-02-05",
"certification_date": "2023-02-05",
"status": "A",
"authorized_official_last_name": "PEDROSO",
"authorized_official_first_name": "DANIELLA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "480-310-8090",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1215591623",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.