Provider Demographics
NPI:1952703100
Name:GUSTAVO FRANZA
Entity type:Organization
Organization Name:GUSTAVO FRANZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANZA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:602-430-1458
Mailing Address - Street 1:9022 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-7864
Mailing Address - Country:US
Mailing Address - Phone:602-430-1458
Mailing Address - Fax:
Practice Address - Street 1:777 E MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2830
Practice Address - Country:US
Practice Address - Phone:602-430-1458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4503251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health