DR. JOHN PHILIP DIBACCO (NPI# 1447480538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447480538 |
| Entity Type | Individual |
| Full Name | DR. JOHN PHILIP DIBACCO |
| Credential | PHD |
| Practice Address |
11811 N Tatum Blvd P115 Phoenix AZ 85028-1614 |
| Practice Telephone | 6029536165 |
| Mailing Telephone | 6029536165 |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2009-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TF0200X |
Psychologist Specialization: Forensic |
131 | NV | Behavioral Health & Social Service Providers |
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
524 | AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536906 | John M. Dibacco | Specialist | 911 Gorman Ave, Ste 103, Elkins, WV 26241-3154 | 2005-05-27 |
| Street Address |
11811 N TATUM BLVD P115 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85028-1614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831188853 | Felice Bershad Goff | Social Worker | 11811 N Tatum Blvd, Ste 3031, Phoenix, AZ 85028-1614 | 2005-10-21 |
| 1427664234 | Latoya Smart | Psychologist | 11811 N Tatum Blvd, Phoenix, AZ 85028-1614 | 2020-09-17 |
| 1841701331 | Passport Health Holdings, LLC | Community Health Worker | 11811 N Tatum Blvd, Suite P132, Phoenix, AZ 85028-1614 | 2017-10-24 |
| 1972990430 | Liberty Hospice & Palliative Care, Inc | Hospice Care, Community Based | 11811 N Tatum Blvd, Suite 3031, Phoenix, AZ 85028-1614 | 2015-04-22 |
| 1184059875 | Hospice Traditions LLC | Hospice Care, Community Based | 11811 N Tatum Blvd, Suite 3031-40, Phoenix, AZ 85028-1614 | 2013-09-12 |
| 1811165996 | Jodi Lynn Stone | Counselor | 11811 N Tatum Blvd, Suite 3031, Phoenix, AZ 85028-1614 | 2008-02-12 |
| 1336334440 | Mark S. Magier | Psychologist | 11811 N Tatum Blvd, Suite 3031, Phoenix, AZ 85028-1614 | 2007-09-11 |
| 1730253311 | The Mandel Center | Clinic/Center | 11811 N Tatum Blvd, Suite 3031, Phoenix, AZ 85028 | 2006-11-17 |
| 1417055781 | Cora Bruno | Counselor | 11811 N Tatum Blvd, 4040, Phoenix, AZ 85028-1614 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235626565 | Celice Korsten | Psychologist | 11020 N. Tatum Blvd., Ste. 100, Phoenix, AZ 85028 | 2018-04-23 |
| 1720591605 | Michele Kaplan | Counselor | 11640 N Tatum Blvd #3096, Phoenix, AZ 85028 | 2017-11-14 |
| 1154840304 | Faustino M. Gonzalez, Md PC | Anesthesiology | 11811 N. Tatum Blvd, Suite 3031, Phoenix, AZ 85028 | 2017-09-19 |
| 1679092514 | Savior Palliative Care LLC | Family Medicine | 4530 E Shea Blvd Ste 175, Phoenix, AZ 85028 | 2017-09-12 |
| 1437688892 | Harmony Behavioral Health | Behavioral Analyst | 3008 E Sierra St, Phoenix, AZ 85028 | 2017-06-08 |
| 1275949224 | Alexander D Garza | Podiatrist | 3101 E Shea Blvd Ste 220, Phoenix, AZ 85028 | 2014-07-09 |
| 1720418379 | Alyssa Hale | Occupational Therapy Assistant | 4600 East Shea Boulevard, Suite 101, Phoenix, AZ 85028 | 2013-11-19 |
| 1932534476 | Stephen Howard Garber | Otolaryngology | 9607 N. 43rd Way, Phoenix, AZ 85028 | 2013-09-03 |
| 1366798050 | Irna Lynn Shamos | Clinical Neuropsychologist | 4516 East Onyx Avenue, Arizona Psychological Diagnostics, Plc, Phoenix, AZ 85028 | 2012-07-31 |
| 1285930925 | Cathy Ann Payne | Nurse Practitioner | 11209 N Tatum Blvd Ste 260, Phoenix, AZ 85028 | 2011-01-27 |
| Find all providers in zip 85028 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205300365 | Eloisa Millan Rodriguez | Psychologist | 3929 W Irwin Ave, Phoenix, AZ 85041-6045 | 2019-01-11 |
| 1902065667 | Gary Alan Freitas | Psychologist | 3250 W Lower Buckeye Rd, Suite 2800, Phoenix, AZ 85009-6729 | 2008-06-06 |
| 1508025974 | Bruce Allen Kushner | Psychologist | 3250 W Lower Buckeye Rd, 2100, Phoenix, AZ 85009-6729 | 2008-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083170641 | Mylena Dashaun Smith | Psychologist | 2812 N. Norwalk St Bldg. 14, Ste 127 & 128, Mesa, AZ 85215 | 2019-02-19 |
| 1093914079 | John A Moran | Psychologist | 7500 E Mcdonald Dr # 400a, Scottsdale, AZ 85250-6052 | 2007-07-11 |
| 1952486961 | Forensic Counseling & Evaluations | Psychologist | 8350 E Raintree Dr, Suite 120, Scottsdale, AZ 85260-2695 | 2006-10-26 |
| 1902072937 | Joseph John Lang | Psychologist | 925 W Baseline Rd, Pmb 105-k5, Tempe, AZ 85283-1100 | 2008-04-30 |
| 1346444114 | Steven R. Gray | Psychologist | 1930 S Alma School Rd, Suite B120, Mesa, AZ 85210-3064 | 2007-06-13 |
| 1114141587 | Gary I Perrin | Psychologist | 5151 E Broadway Blvd, Suite 720, Tucson, AZ 85711-3705 | 2007-04-13 |
| 1235352352 | Ashley Bruce Hart II | Psychologist | 106 E 1st St, Suite D, Yuma, AZ 85364-1450 | 2007-04-10 |
| 1215051750 | Cheryl Lee Karp | Psychologist | 3060 N Swan Rd, Tucson, AZ 85712-1225 | 2007-03-19 |
| 1285719278 | David Weinstock | Psychologist | 8350 E Raintree Dr, Suite 120, Scottsdale, AZ 85260-2695 | 2006-10-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.