Healthcare Provider Details

I. General information

NPI: 1922197904
Provider Name (Legal Business Name): GERALD DAVID ZIRIN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8124 E CACTUS RD STE 410
SCOTTSDALE AZ
85260-5262
US

IV. Provider business mailing address

2710 E EMILE ZOLA AVE
PHOENIX AZ
85032-5921
US

V. Phone/Fax

Practice location:
  • Phone: 602-363-2872
  • Fax: 888-839-1279
Mailing address:
  • Phone: 602-363-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4058
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7307
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: