Individual
DR. JON JAY VANDOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
7330 N 16TH ST STE A120, PHOENIX, AZ 85020-8201
(480) 699-6968
(480) 666-4803
Mailing address
PO BOX 13361, SCOTTSDALE, AZ 85267-3361
(480) 699-6968
(480) 666-4803
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2081
AZ
103T00000X
Psychologist
2081
AZ
103TA0700X
Adult Development & Aging Psychologist
2081
AZ
103TB0200X
Cognitive & Behavioral Psychologist
2081
AZ
103TC0700X
Clinical Psychologist
2081
AZ
103TF0200X
Forensic Psychologist
2081
AZ
103TR0400X
Rehabilitation Psychologist
2081
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z60229
MEDICARE GROUP PIN
AZ
Enumeration date
01/25/2007
Last updated
08/30/2025
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