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NPI Code Detail

MEDICARE: DR. DAVID PRINCE PSY.D.

MEDICARE: DR. DAVID PRINCE PSY.D.
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
1103TC0700XClinical Psychologist3295AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111712479OTHERAZCAQH

General Provider Information

NPI Number : 1659382489
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID PRINCE PSY.D.
Provider Business Mailing Address
First Line : 11022 S 51ST ST STE 250
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-4319
Country : US
Telephone Number : 480-940-1104
Fax Number : 866-572-4225
Provider Business Practice Location Address
First Line : 11022 S 51ST ST STE 250
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-4319
Country : US
Telephone Number : 480-940-1104
Fax Number : 866-572-4225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 05/25/2026

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