Provider Demographics
NPI:1811336480
Name:ARIZPE PSYCHOLOGY GROUP, INC
Entity type:Organization
Organization Name:ARIZPE PSYCHOLOGY GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAILEY-ARIZPE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:480-529-0959
Mailing Address - Street 1:10210 N 92ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4509
Mailing Address - Country:US
Mailing Address - Phone:480-529-0959
Mailing Address - Fax:310-988-2883
Practice Address - Street 1:10210 N 92ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4509
Practice Address - Country:US
Practice Address - Phone:480-529-0959
Practice Address - Fax:310-988-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3796OtherAZ LICENSE
CAPSY17402OtherLICENSE