Provider Demographics
NPI:1316931629
Name:VENTURA-COOK, ELIZABETH E (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:E
Last Name:VENTURA-COOK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 E SAN SALVADOR DR
Mailing Address - Street 2:SUITE 228
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5527
Mailing Address - Country:US
Mailing Address - Phone:480-718-5054
Mailing Address - Fax:480-718-5054
Practice Address - Street 1:9414 E SAN SALVADOR DR
Practice Address - Street 2:SUITE 228
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5527
Practice Address - Country:US
Practice Address - Phone:480-718-5054
Practice Address - Fax:480-718-5054
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3587103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ131417Medicare PIN