Healthcare Provider Details

I. General information

NPI: 1063125664
Provider Name (Legal Business Name): PHOENIX POINTE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 E BROADWAY RD STE 113
TEMPE AZ
85282-1634
US

IV. Provider business mailing address

1845 E BROADWAY RD STE 113
TEMPE AZ
85282-1634
US

V. Phone/Fax

Practice location:
  • Phone: 480-378-6323
  • Fax: 877-409-1511
Mailing address:
  • Phone: 480-378-6323
  • Fax: 877-409-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ZAKARY CALL
Title or Position: PROVIDER
Credential:
Phone: 801-549-7073