Healthcare Provider Details

I. General information

NPI: 1609906932
Provider Name (Legal Business Name): ARIZONA NEUROPSYCHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9832 N HAYDEN RD SUITE 106
SCOTTSDALE AZ
85258-1298
US

IV. Provider business mailing address

9832 N HAYDEN RD SUITE 106
SCOTTSDALE AZ
85258-1298
US

V. Phone/Fax

Practice location:
  • Phone: 480-945-3475
  • Fax: 480-922-5569
Mailing address:
  • Phone: 480-945-3475
  • Fax: 480-922-5569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN PAGE O'BRIEN
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 480-945-3475