EAST VALLEY JOINT CLINIC LLC NPI 1952771024

NPI Information

NPI: 1952771024
Provider Name: EAST VALLEY JOINT CLINIC LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
2231 E PECOS ROAD
STE 4
CHANDLER, AZ
ZIP 85225
Phone: (480) 718-1444
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EAST VALLEY JOINT CLINIC LLC is a family nurse practitioner in Chandler, AZ. EAST VALLEY JOINT CLINIC LLC NPI is 1952771024. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2231 E PECOS ROAD
STE 4
CHANDLER, AZ
ZIP 85225-228
Phone: (480) 718-1444
Fax: (480) 718-7729

The provider's authorized official is Amy Berkhout .
The authorized official title is Co-owner and has the following contact phone number (831) 227-6079.

The enumeration date for this NPI number is 10/2/2015 and was last updated on 1/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	AP5244	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100091	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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