Individual
MR. PAUL ERIC LARRALDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
6619 N SCOTTSDALE RD STE 4, SCOTTSDALE, AZ 85250-4421
(602) 910-6519
(602) 910-6519
Mailing address
6619 N SCOTTSDALE RD STE 4, SCOTTSDALE, AZ 85250-4421
(602) 910-6519
(602) 910-6519
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP5217
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
859900
AHCCCS
AZ
05
—
859900
—
AZ
01
—
Z162628
MEDICARE
AZ
Enumeration date
10/06/2013
Last updated
12/16/2020
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