Healthcare Provider Details

I. General information

NPI: 1992384150
Provider Name (Legal Business Name): DANIELLE M WESTON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 E CAMELBACK RD STE 600
PHOENIX AZ
85016-3493
US

IV. Provider business mailing address

4281 E AUGUSTA AVE
CHANDLER AZ
85249-7003
US

V. Phone/Fax

Practice location:
  • Phone: 602-387-5313
  • Fax:
Mailing address:
  • Phone: 480-709-9655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-005360
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: