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General NPI Number Information
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NPI Number | 1306916945
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Entity Type | Organization
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Legal Business Name | YUMA BIO BEHAVIORAL CLINICAL PSYCHOLOGY
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 2295 S ELKS LN
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City | YUMA
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State | AZ
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Zip | 85364-6258
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Country | US
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Telephone | 928-314-4500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4032
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City | YUMA
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State | AZ
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Zip | 85366-4032
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Country | US
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Telephone | 928-314-4500
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JAMES PARKER
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Credential | PHD
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Telephone | 928-314-4500
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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 | 3334
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License Number State | AZ
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