Healthcare Provider Details

I. General information

NPI: 1659263945
Provider Name (Legal Business Name): MONICA ACEVEDO MOLINA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W THOMAS RD STE 315
PHOENIX AZ
85013-4422
US

IV. Provider business mailing address

240 W THOMAS RD STE 301
PHOENIX AZ
85013-4407
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3671
  • Fax: 602-406-6115
Mailing address:
  • Phone: 602-406-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number005903
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: