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General NPI Number Information
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NPI Number | 1154499853
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Entity Type | Individual
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Provider Name | PEDRO RAMON CHOCA PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 4131 N 24TH ST STE. B102
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City | PHOENIX
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State | AZ
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Zip | 85016-6262
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Country | US
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Telephone | 602-955-6632
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Fax | 602-381-1341
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Provider Business Mailing Address
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Address Line | 2500 W UTOPIA RD STE. 100
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City | PHOENIX
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State | AZ
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Zip | 85027-4171
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Country | US
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Telephone | 623-434-6200
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Fax | 623-780-3752
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC-0638
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 847
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License Number State | AZ
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