Healthcare Provider Details

I. General information

NPI: 1770130320
Provider Name (Legal Business Name): JOHN MARK CZAPLEWSKI PSY. D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7776 S POINTE PKWY W STE 250
PHOENIX AZ
85044-5428
US

IV. Provider business mailing address

10215 E CATALYST AVE
MESA AZ
85212-8105
US

V. Phone/Fax

Practice location:
  • Phone: 480-382-7761
  • Fax:
Mailing address:
  • Phone: 402-957-6371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number005602
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: