Healthcare Provider Details

I. General information

NPI: 1578163200
Provider Name (Legal Business Name): AHMAD ZAFAR SADEK PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1362 S VINEYARD
MESA AZ
85210-8933
US

IV. Provider business mailing address

1362 S VINEYARD APT 1067
MESA AZ
85210-8945
US

V. Phone/Fax

Practice location:
  • Phone: 480-719-0812
  • Fax:
Mailing address:
  • Phone: 480-719-0812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY61117678
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-005320
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: