| Desert Vista Neuropsychological Specialists, Pllc | |
|
7227 N 16th St Suite 219 Phoenix AZ 85020-5251 | |
| (602) 216-6900 | |
| (602) 371-9889 |
| Full Name | Desert Vista Neuropsychological Specialists, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 7227 N 16th St, Phoenix, Arizona |
| Authorized Official Name and Position | John Robert Walker (NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 4806889635 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Vista Neuropsychological Specialists, Pllc 7227 N 16th St Suite 219 Phoenix AZ 85020-5251 Ph: (602) 216-6900 | Desert Vista Neuropsychological Specialists, Pllc 7227 N 16th St Suite 219 Phoenix AZ 85020-5251 Ph: (602) 216-6900 |
| NPI Number | 1821283342 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 05/28/2013 |
| Medicare PECOS PAC ID | 5395986731 |
|---|---|
| Medicare Enrollment ID | O20130726000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821283342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 3593 (Arizona) | Primary |
| Provider Name | Lana N Susskind-wilder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376618520 PECOS PAC ID: 8123122066 Enrollment ID: I20070402000511 |
| Provider Name | Susanne N Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700902764 PECOS PAC ID: 8921179342 Enrollment ID: I20080612000362 |
| Provider Name | John R Walker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871634485 PECOS PAC ID: 1557432978 Enrollment ID: I20080612000376 |
| Provider Name | Surabhi Y Patwardhan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164864161 PECOS PAC ID: 4486871894 Enrollment ID: I20140808000215 |
| Provider Name | Conrad Spezzacatena |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205382777 PECOS PAC ID: 6800184763 Enrollment ID: I20161007001114 |
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