Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY-005188 | AZ |
Y | 103T00000X | Psychologist | PSY-005188 | AZ |
N | 102L00000X | Psychologist | PSY-1718 | HI |
N | 103T00000X | Psychologist | PSY-1718 | HI |
NPI | 1013205822 |
---|---|
Provider Name | Dr. Nanako Negome-Kapur |
First Address | Scottsdale, AZ 85258-4583 |
Second Address | Glendale, AZ 85308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2011 |
Last Update Date | 28/10/2019 |