Provider Demographics
NPI:1649388760
Name:PAULUK, WENDY JEAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:JEAN
Last Name:PAULUK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9421 W. BELL ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351
Mailing Address - Country:US
Mailing Address - Phone:623-583-2900
Mailing Address - Fax:623-583-2700
Practice Address - Street 1:9421 W BELL RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1361
Practice Address - Country:US
Practice Address - Phone:623-583-2900
Practice Address - Fax:623-583-2700
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0419103TC0700X
AZ4066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ476024OtherARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
NV002602095Medicaid
NV880506362OtherTIN
NVV35185Medicare ID - Type Unspecified