Provider Demographics
NPI:1063500098
Name:VOLKERTS, PATRICIA (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:VOLKERTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3444 N COUNTRY CLUB RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1200
Mailing Address - Country:US
Mailing Address - Phone:520-325-2723
Mailing Address - Fax:520-325-7207
Practice Address - Street 1:3444 N COUNTRY CLUB RD
Practice Address - Street 2:SUITE 202
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1200
Practice Address - Country:US
Practice Address - Phone:520-325-2723
Practice Address - Fax:520-325-7207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0136350OtherBCBS PROVIDER NUMBER
AZ1Z2648OtherHEALTHNET PROVIDER NUMBER
AZ1Z2648OtherHEALTHNET PROVIDER NUMBER