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 | 207ND0900X | Dermatology | Dermatopathology | 36137 | | No |
| 2 | 207ZD0900X | Pathology | Dermatopathology | 36137 | ARIZONA | No |
| 3 | 207ZF0201X | Pathology | Forensic Pathology | 36137 | ARIZONA | No |
| 4 | 207ZP0102X | Pathology | Anatomic Pathology & Clinical Pathology | 36137 | ARIZONA | No |
| 5 | 2084B0002X | Psychiatry & Neurology | Obesity Medicine | 40751 | ARIZONA | No |
| 6 | 2084F0202X | Psychiatry & Neurology | Forensic Psychiatry | 40751 | ARIZONA | No |
| 7 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | 40751 | ARIZONA | No |
| 8 | 2084P0804X | Psychiatry & Neurology | Child & Adolescent Psychiatry | 40751 | ARIZONA | No |
| 9 | 2084P0805X | Psychiatry & Neurology | Geriatric Psychiatry | 40751 | ARIZONA | No |
| 10 | 2084P2900X | Psychiatry & Neurology | Pain Medicine | 40751 | ARIZONA | No |
| 11 | 363A00000X | Physician Assistant | | 3367 | ARIZONA | No |
| 12 | 363AM0700X | Physician Assistant | Medical | 3367 | ARIZONA | No |
| 13 | 363AS0400X | Physician Assistant | Surgical | 3367 | ARIZONA | No |
| 14 | 2084P0800X | Psychiatry & Neurology | Psychiatry | 40751 | ARIZONA | Yes |