Healthcare Provider Details

I. General information

NPI: 1285319400
Provider Name (Legal Business Name): ESTEBAN VIRUET SANCHEZ PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E MCDOWELL RD FL 3
PHOENIX AZ
85006-2506
US

IV. Provider business mailing address

755 E MCDOWELL RD FL 3
PHOENIX AZ
85006-2506
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-3300
  • Fax: 602-521-3246
Mailing address:
  • Phone: 602-521-3300
  • Fax: 602-521-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number025833
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: