MEDICARE: PEDIATRIC NEUROPSYCHOLOGY OF THE VALLEY

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
1	103G00000X	Clinical Neuropsychologist

General Provider Information

NPI Number	:	1255275863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC NEUROPSYCHOLOGY OF THE VALLEY

Provider Business Mailing Address
First Line	:	14362 N FRANK LLOYD WRIGHT BLVD STE 1000
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-8847
Country	:	US
Telephone Number	:	480-485-7106
Fax Number	:

Provider Business Practice Location Address
First Line	:	14362 N FRANK LLOYD WRIGHT BLVD STE 1113
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-8846
Country	:	US
Telephone Number	:	480-485-7106
Fax Number	:

Authorized Official
Title or Position	:	NEUROPSYCHOLOGIST
Name	:	DR. KRISTIN D CROCFER
Credential	:	PSYD
Telephone Number	:	480-485-7106

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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