Provider Demographics
NPI:1346037389
Name:EAST VALLEY PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:EAST VALLEY PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CHRIST
Authorized Official - Last Name:CARACCI
Authorized Official - Suffix:III
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:866-387-7924
Mailing Address - Street 1:5227 N 7TH ST STE 18035
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2802
Mailing Address - Country:US
Mailing Address - Phone:866-387-7924
Mailing Address - Fax:
Practice Address - Street 1:4365 E PECOS RD STE 138
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-8053
Practice Address - Country:US
Practice Address - Phone:866-387-7924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty