Healthcare Provider Details

I. General information

NPI: 1558575035
Provider Name (Legal Business Name): JAMES SEWARD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E WILLETTA ST
PHOENIX AZ
85006-2727
US

IV. Provider business mailing address

901 E WILLETTA ST
PHOENIX AZ
85006-2727
US

V. Phone/Fax

Practice location:
  • Phone: 602-239-6900
  • Fax: 602-239-6925
Mailing address:
  • Phone: 602-239-6900
  • Fax: 602-239-6925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3465
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3465
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number3465
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: