Healthcare Provider Details

I. General information

NPI: 1417810383
Provider Name (Legal Business Name): ANCHETA PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20325 N 51ST AVE STE 168
GLENDALE AZ
85308-4624
US

IV. Provider business mailing address

303 S WATER ST STE 230
HENDERSON NV
89015-7308
US

V. Phone/Fax

Practice location:
  • Phone: 408-813-8269
  • Fax:
Mailing address:
  • Phone: 702-763-7321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MARY ANCHETA
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 408-813-8269