Organization
PSYCH NETWORK P.C.
Active
Organization
PSYCH NETWORK P.C.
Active
Other names
Psychology Network
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON H DE JESUS PH.D. (PRESIDENT)
(520) 318-4930
Entity
Organization
Contact information
Practice address
1011 N CRAYCROFT RD, SUITE 400, TUCSON, AZ 85711-7309
(520) 318-4930
Mailing address
8987 E TANQUE VERDE RD, SUITE 309-383, TUCSON, AZ 85749-9610
(520) 318-4930
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
AZ
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZPHD1806B
MEDICARE PTAN
AZ
Enumeration date
08/28/2012
Last updated
08/28/2012
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