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General NPI Number Information
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NPI Number | 1295404192
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Entity Type | Organization
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Legal Business Name | DESERT SPIRIT PSYCHOLOGY
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 10401 E MCDOWELL MOUNTAIN RANCH RD STE 130
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7525
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Country | US
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Telephone | 714-679-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 10115 E MOUNTAIN VIEW RD UNIT 1084
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-6315
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Country | US
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Telephone | 714-679-6565
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHIVA SOBHANIAN
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Credential |
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Telephone | 714-679-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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