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General NPI Number Information
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NPI Number | 1063125664
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Entity Type | Organization
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Legal Business Name | PHOENIX POINTE PSYCHIATRY LLC
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Dates
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Enumeration Date | 12/29/2022
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1845 E BROADWAY RD STE 113
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City | TEMPE
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State | AZ
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Zip | 85282-1634
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Country | US
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Telephone | 480-378-6323
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Fax | 877-409-1511
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Provider Business Mailing Address
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Address Line | 1845 E BROADWAY RD STE 113
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City | TEMPE
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State | AZ
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Zip | 85282-1634
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Country | US
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Telephone | 480-378-6323
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Fax | 877-409-1511
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Authorized Official
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Title or Position | PROVIDER
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Name | ZAKARY CALL
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Credential |
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Telephone | 801-549-7073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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