Provider Demographics
NPI:1366686321
Name:PICARDO, MARY ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:PICARDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 45019
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-5019
Mailing Address - Country:US
Mailing Address - Phone:623-869-9050
Mailing Address - Fax:623-869-9486
Practice Address - Street 1:2800 W PINNACLE PEAK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1000
Practice Address - Country:US
Practice Address - Phone:623-869-9050
Practice Address - Fax:623-869-9486
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ15862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry