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PONDEROSA PSYCHIATRY PLLC
NPI 1548012966
Nurse Practitioner - Psychiatric/Mental Health in Phoenix, AZ

Active since April 02, 2024
2030 W BASELINE RD # 182-8355, PHOENIX, AZ 85041(928) 235-2927(928) 268-0289 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ponderosa Psychiatry Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PONDEROSA PSYCHIATRY PLLC (NPI 1548012966) is a healthcare organization registered as a psychiatric/mental health in Phoenix, Arizona and active in the NPI registry since April 2024. The organization lists Cameo E Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1548012966
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NamePONDEROSA PSYCHIATRY PLLC
Location Address2030 W BASELINE RD # 182-8355Phoenix, AZ 85041-6574
Mailing Address2030 W Baseline Rd # 182-8355Phoenix, AZ 85041-6574 · (928) 235-2927 · Fax (928) 268-0289
Phone(928) 235-2927
Fax(928) 268-0289
Organization SubpartNo
Authorized OfficialCameo E JohnsonOwner · (928) 235-2927
Enumeration DateApril 2, 2024
Last NPPES UpdateApril 4, 2024
NPPES CertifiedApril 4, 2024
✔ NPI 1548012966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
2030 W BASELINE RD # 182-8355, Phoenix, AZ 85041
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMEO JOHNSON NP, PLLC
Nurse Practitioner (Psychiatric/Mental Health)
2030 W BASELINE RD # 182-8355
PHOENIX, AZ 85041
Maricopa County (928) 235-2927
CAMEO ELIZABETH JOHNSON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
2030 W BASELINE RD # 182-8355
PHOENIX, AZ 85041
Maricopa County (928) 235-2927

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ponderosa Psychiatry PLLC's NPI number?

The NPI number for Ponderosa Psychiatry PLLC is 1548012966. It was assigned to this organization in the NPPES registry on April 2, 2024.

Where is Ponderosa Psychiatry PLLC located?

Ponderosa Psychiatry PLLC is located at 2030 W Baseline Rd # 182-8355, Phoenix, AZ 85041. The listed phone number is (928) 235-2927.

What is Ponderosa Psychiatry PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Ponderosa Psychiatry PLLC was last updated on April 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.