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General NPI Number Information
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NPI Number | 1235785395
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Entity Type | Organization
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Legal Business Name | PEDROSO PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 02/05/2023
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Provider Practice Location Address
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Address Line | 11201 N TATUM BLVD STE 300
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City | PHOENIX
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State | AZ
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Zip | 85028-6039
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Country | US
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Telephone | 480-310-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 11201 N TATUM BLVD STE 300
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City | PHOENIX
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State | AZ
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Zip | 85028-6039
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Country | US
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Telephone | 480-310-8090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIELLA PEDROSO
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Credential | PSY.D.
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Telephone | 480-310-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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