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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