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Individual

DR. JENNIFER J BORTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
2929 E CAMELBACK RD, STE 114, PHOENIX, AZ 85016-4425
(480) 795-4787
(480) 795-7778
Mailing address
34522 N SCOTTSDALE RD STE 120-227, SCOTTSDALE, AZ 85266-1224
(480) 795-4787
(480) 795-7778

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2060
AZ
103TC0700X
Clinical Psychologist
2060
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209016
AZ
01
680011757
RAILROAD MEDICARE
AZ
01
86080015085259A620
TRIWEST
AZ
Enumeration date
12/27/2005
Last updated
12/01/2019
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