Provider Demographics
NPI:1508227687
Name:VERATTI, LYDIA CHRISTINE (FAMILY PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:CHRISTINE
Last Name:VERATTI
Suffix:
Gender:F
Credentials:FAMILY PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E EARLL DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2634
Mailing Address - Country:US
Mailing Address - Phone:480-471-8560
Mailing Address - Fax:888-979-8197
Practice Address - Street 1:17505 N 79TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8726
Practice Address - Country:US
Practice Address - Phone:480-471-8560
Practice Address - Fax:888-979-8197
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8539363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health