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General NPI Number Information
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NPI Number | 1194607697
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Entity Type | Individual
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Provider Name | JAMES R IZZO PHD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1000 N 90TH ST STE 200
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City | OMAHA
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State | NE
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Zip | 68114-2766
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Country | US
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Telephone | 402-955-3900
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Fax | 402-955-3920
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Provider Business Mailing Address
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Address Line | PO BOX 24607
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City | OMAHA
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State | NE
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Zip | 68124-0607
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Country | US
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Telephone | 402-955-5400
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Fax | 402-955-3674
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1192
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License Number State | NE
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