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NPI Code Detail

MEDICARE: PATRICIA DIANE RAYA PH.D., LAC

MEDICARE: PATRICIA DIANE RAYA PH.D., LAC
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
1101YP2500XProfessional Counselor18651AZ

General Provider Information

NPI Number : 1538792965
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA DIANE RAYA PH.D., LAC
Provider Business Mailing Address
First Line : 7349 N VIA PASEO DEL SUR # 515-254
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-3765
Country : US
Telephone Number : 480-309-4736
Fax Number :
Provider Business Practice Location Address
First Line : 9825 N 95TH ST STE 101
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4590
Country : US
Telephone Number : 480-941-4247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2020
Last Update Date : 02/13/2020

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