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NPI Code Detail

MEDICARE: JADA PHILLIPS

MEDICARE: JADA PHILLIPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianAZ

General Provider Information

NPI Number : 1487502431
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADA PHILLIPS
Provider Business Mailing Address
First Line : 2005 W 14TH ST STE 121
Second Line :
City : TEMPE
State : AZ
Zip : 85281-6917
Country : US
Telephone Number : 480-863-0763
Fax Number :
Provider Business Practice Location Address
First Line : 2005 W 14TH ST STE 121
Second Line :
City : TEMPE
State : AZ
Zip : 85281-6917
Country : US
Telephone Number : 480-863-0763
Fax Number : 480-898-7419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ JADA PHILLIPS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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