MRS. TRACEY RENEE SRIDHARAN (NPI# 1073654067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073654067 |
| Entity Type | Individual |
| Full Name | MRS. TRACEY RENEE SRIDHARAN |
| Credential | ED.S., NCSP |
| Practice Address |
2043 N 64th Dr Phoenix AZ 85035-3424 |
| Mailing Address |
2513 W Park St Phoenix AZ 85041-6488 |
| Practice Telephone | 6236915518 |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
3415771 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
2043 N 64TH DR |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85035-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669983185 | Aerron Ann Smith | Registered Nurse | 2043 N 64th Dr, Phoenix, AZ 85035-3424 | 2017-10-24 |
| 1396113346 | Tara Anne Toma | Licensed Practical Nurse | 2043 N 64th Dr, Phoenix, AZ 85035-3424 | 2015-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912420621 | Safe Run Non Emergency Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 7205 W Mcdowell Rd, Apt 1073, Phoenix, AZ 85035 | 2017-07-25 |
| 1710435581 | Aimee Uwimana | Nurse Practitioner | 5030 W. Mcdowell Rd. Ste. 16, Phoenix, AZ 85035 | 2016-09-21 |
| 1528427317 | Akdhc, LLC | Internal Medicine | 4901 W Mcdowell Rd, Phoenix, AZ 85035 | 2016-02-22 |
| 1285921544 | Tasnim Khalife | Family Medicine | 2303 N. 75th Ave., Phoenix, AZ 85035 | 2011-07-06 |
| 1528210192 | Scott Alan Ulrick | Chiropractor | 5120 W. Mcdowell Rd, Phoenix, AZ 85035 | 2008-10-15 |
| 1467627331 | Robert Anthony Bembenek | Chiropractor | 5030 W Mcdowell Suite 10, Phx, AZ 85035 | 2008-04-23 |
| 1164569935 | Roy Song | Dentist | 1820 N 75th Ave, Suite 112, Phoenix, AZ 85035 | 2007-01-31 |
| 1659418994 | Western Dental of Arizona, Inc. | Dentist | 1820 N. 75th Ave., Suite #112, Phoenix, AZ 85035 | 2007-01-30 |
| 1982774824 | Nationwide Vision Center, LLC | Technician/Technologist | 1820 North 75th Avenue, Suite 102, Phoenix, AZ 85035 | 2006-11-08 |
| 1396748976 | Kris Morshedian | Internal Medicine | 4901 W Mcdowell Rd., Phoenix, AZ 85035 | 2005-05-27 |
| Find all providers in zip 85035 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386171650 | Tracey Denise Manigault | Psychologist | 8900 N Central Ave Ste 105, Phoenix, AZ 85020-2846 | 2017-05-17 |
| 1316326044 | Nicole Nielsen | Psychologist | 622 E Nicolet Ave, Phoenix, AZ 85020-4943 | 2015-05-27 |
| 1770915985 | Jill Larkin | Psychologist | 7747 W Pipestone Pl, Phoenix, AZ 85035-5096 | 2013-07-30 |
| 1639488570 | Jacqueline Relyea | Psychologist | 6550 S 27th Ave, Phoenix, AZ 85041-5287 | 2010-09-27 |
| 1740597541 | Kyle Vessell | Psychologist | 2625 E Cheryl Dr, Phoenix, AZ 85028-4319 | 2010-09-01 |
| 1972819084 | Carl Grasso | Psychologist | 31413 N 20th Ave, Phoenix, AZ 85085-7021 | 2010-08-26 |
| 1568778132 | Deborah Vogt Purscell | Psychologist | 1247 E Glenhaven Dr, Phoenix, AZ 85048-4734 | 2010-08-20 |
| 1548575426 | Casie Rene'e Blount | Psychologist | 3609 N 27th St, Phoenix, AZ 85016-6747 | 2010-08-16 |
| 1093034209 | Tiffani Allen | Psychologist | 1002 E Sheridan St, Phoenix, AZ 85006-1647 | 2010-05-27 |
| 1205164167 | Parul Saxena | Psychologist | 8525 W Osborn Road, Desert Horizon School, Phoenix, AZ 85037 | 2009-12-03 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.