MR. MATTHEW DAVID WICKSTROM (NPI# 1801040878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801040878 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW DAVID WICKSTROM |
| Practice Address |
27880 N 64th Street Scottsdale AZ 85262 |
| Mailing Address |
29862 N Tatum Blvd 2069 Cave Creek AZ 85331-5860 |
| Practice Telephone | 4802028454 |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
4058847 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
27880 N 64TH STREET |
| City | SCOTTSDALE |
| State | AZ |
| Zip Code | 85262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043773666 | Helpful Hands Home Care | Home Health Aide | 36595 N Montalcino Road, Scottsdale, AZ 85262 | 2019-04-10 |
| 1548789415 | Paige Richelle Breeden | Behavioral Analyst | 14608 E Skinner Dr, Scottsdale, AZ 85262 | 2017-09-12 |
| 1518342625 | Golf Health & Performance LLC | Physical Therapist | 10225 E Desert Mountain Dr, Scottsville, AZ 85262 | 2015-07-30 |
| 1649555608 | Terry Stephen Vitez | Anesthesiology | 9626 E. Taos Drive, Scottsdale, AZ 85262 | 2011-10-20 |
| 1578855573 | First Lifeconnect, LLC | Emergency Response System Companies | 13857 E Hawknest Road, Scottsdale, AZ 85262 | 2011-05-09 |
| 1639332802 | New Hope Ultimate | Clinic/Center | 13735 E Brookhart Way, Scottsdale, AZ 85262 | 2008-07-08 |
| 1548432701 | Talia Lavor | Physician Assistant | 28150 N Alma School Pkwy, Suite 103-455, Scottsdale, AZ 85262 | 2008-03-27 |
| 1548485907 | Lynn Klein | Psychologist | 4222 E. Camelback Rd, Suite 230h, Scottsdale, AZ 85262 | 2007-04-13 |
| 1912040510 | Jamie Linn Hestrup | Social Worker | 5802 E. Dove Valley Road, Scottsdale, AZ 85262 | 2007-02-14 |
| 1396726717 | Jeffrey Cohen | Psychiatry & Neurology | 9723 E. Granite Peak Trail, Scottsdale, AZ 85262 | 2005-11-11 |
| Find all providers in zip 85262 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386037604 | Izabela Lange | Psychologist | 8333 E. Via Paseo Del Norte, 1031, Scottsdale, AZ 85258-9998 | 2015-03-11 |
| 1073855078 | Jennifer Marie Heil | Psychologist | 10055 N 142nd St Unit 1170, Scottsdale, AZ 85259-5525 | 2013-03-18 |
| 1255632360 | Ann E Bauermeister | Psychologist | 5049 E Sunnyside Dr, Scottsdale, AZ 85254-4672 | 2010-11-04 |
| 1366772659 | Barbara Konikowski | Psychologist | 6732 E Hubbell St, Scottsdale, AZ 85257-2528 | 2010-01-08 |
| 1437305489 | Marisa Beth Mackey-boyd | Psychologist | 8531 E San Jacinto Dr, Scottsdale, AZ 85258-2564 | 2008-08-11 |
| 1083827547 | Dalia Rostenberg | Psychologist | 6861 E Osborn Rd Unit D, Scottsdale, AZ 85251 | 2007-05-08 |
| 1376671875 | Carl Joseph Patrasso | Psychologist | 8566 E Mcdonald Dr, Scottsdale, AZ 85250-6329 | 2007-02-28 |
| 1811022304 | Howard C. Rush | Psychologist | 8755 E Monterey Way, Scottsdale, AZ 85251-5020 | 2007-02-23 |
| 1649317231 | Shannon L Blair | Psychologist | 6320 N 82nd St, Scottsdale, AZ 85250-5611 | 2007-01-31 |
| 1083769400 | Judy Ann Cluff | Psychologist | 701 N Miller Rd, Scottsdale, AZ 85257-4610 | 2007-01-24 |
| Find all providers in SCOTTSDALE | ||||
| City | SCOTTSDALE |
| Zip Code | 85262 |
Please comment or provide details below to improve the information on MR. MATTHEW DAVID WICKSTROM.
| 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.