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Organization
PRESTIGE PSYCHIATRIC PROFESSIONALS, LLC
Active
Organization
PRESTIGE PSYCHIATRIC PROFESSIONALS, LLC
Active
Other names
Prestige Psychiatric Professionals
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL ERIC LARRALDE PMHNP-BC (MEMBER)
(602) 910-6519
Entity
Organization
Contact information
Practice address
8414 E SHEA BLVD, SUITE 102, SCOTTSDALE, AZ 85260-6665
(602) 910-6519
(602) 910-6519
Mailing address
3120 W CAREFREE HWY, STE 1-602, PHOENIX, AZ 85086-3201
(602) 910-6519
(602) 910-6519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11647
AZ
101YP2500X
Professional Counselor
LPC-11774
AZ
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN147893
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP5217
AZ
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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