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NPI Code Detail

MEDICARE: DR. PEDRO RAMON CHOCA PH.D.

MEDICARE: DR. PEDRO RAMON CHOCA PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLISAC-0638AZ
2103T00000XPsychologist847AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1763290OTHERAETNA BEHAVIORAL HEALTH
2AZ0616080OTHERAZBLUE CROSS BLUE SHIELD AZ
3068297000OTHERMAGELLAN BEHAVIORAL HEALT

General Provider Information

NPI Number : 1154499853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEDRO RAMON CHOCA PH.D.
Provider Business Mailing Address
First Line : 2500 W UTOPIA RD
Second Line : STE. 100
City : PHOENIX
State : AZ
Zip : 85027-4171
Country : US
Telephone Number : 623-434-6200
Fax Number : 623-780-3752
Provider Business Practice Location Address
First Line : 4131 N 24TH ST
Second Line : STE. B102
City : PHOENIX
State : AZ
Zip : 85016-6262
Country : US
Telephone Number : 602-955-6632
Fax Number : 602-381-1341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 09/19/2013

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