MICHAEL JOSEPH REDIVO (NPI# 1790938157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790938157 |
| Entity Type | Individual |
| Full Name | MICHAEL JOSEPH REDIVO |
| Credential | PH.D. |
| Practice Address |
4229 N 16th St Phoenix AZ 85016-5318 |
| Practice Telephone | 6022774482 |
| Practice Fax Number | 6022774483 |
| Mailing Telephone | 6022774482 |
| Mailing Fax Number | 6022774483 |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2008-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
3433 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
4229 N 16TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699954339 | Jackie Pilla | Counselor | 4229 N 16th St, Phoenix, AZ 85016-5318 | 2007-10-30 |
| 1750615902 | Silvia Mora | Social Worker | 4229 N 16th St, Phoenix, AZ 85016-5318 | 2009-09-21 |
| 1669625018 | Christopher Ryan Sanders | Student in an Organized Health Care Education/Training Program | 4229 N 16th St, Phoenix, AZ 85016-5318 | 2008-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477928471 | Erin Testa | Psychologist | 7600 N 16th St Ste 218, Phoenix, AZ 85020 | 2015-12-02 |
| 1801919840 | Tyra Maria Ripley | Psychologist | 3120 W Cholla St, Phoenix, AZ 85029-4113 | 2007-04-06 |
| 1205988474 | Terrence M Matteo | Psychologist | 10616 S 43rd St, Phoenix, AZ 85044-1305 | 2007-01-17 |
| 1942221858 | Sean Conway Mcdevitt | Psychologist | 7330 North 16th Street, A120, Phoenix, AZ 85020 | 2006-07-23 |
| 1063023836 | Daniel Wechsler | Psychologist | 2225 N 16th St, Phoenix, AZ 85006-1823 | 2020-08-13 |
| 1679039689 | Youth World Education Project, Inc | Psychologist | 9617 N Metro Pkwy W, Phoenix, AZ 85051-1400 | 2019-02-14 |
| 1053805325 | Nicole Burt | Psychologist | 7600 N 16th St Ste 110, Phoenix, AZ 85020-4446 | 2018-06-19 |
| 1831459650 | Gina De Simone | Psychologist | 7330 N 16th St, Suite C200, Phoenix, AZ 85020-5237 | 2012-05-26 |
| 1811257264 | Lisa Elder Outhier | Psychologist | 7330 N 16th St, C-200, Phoenix, AZ 85020-5237 | 2012-05-19 |
| 1053692046 | Christina Whalen | Psychologist | 300 N 18th St, Phoenix, AZ 85006-4103 | 2011-09-02 |
| 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.