Provider Demographics
NPI:1770633869
Name:TAPIA, HUGO ALBERTO (PHD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:ALBERTO
Last Name:TAPIA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 S LA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-5004
Mailing Address - Country:US
Mailing Address - Phone:480-776-7509
Mailing Address - Fax:480-706-7976
Practice Address - Street 1:1250 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1404
Practice Address - Country:US
Practice Address - Phone:480-776-7509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ729501Medicare ID - Type Unspecified