Doctor Name: | JAMES VIZZA |
NPI Number: | 1851388078 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MDIV PSYD |
License Number: | PS004871L |
Business Practice Address: | 600 Somerset Ave Windber, PA - 159631331 |
Business Phone Number: | 8144673613 |
Business Fax Number: | 8144673629 |
Mailing Address: | 1407 Eisenhower Blvd, Ste 104 JOHNSTOWN |
State: | PA |
Postal Code: | 159043262 |
Phone Number: | 8142691494 |
Fax Number: | 8142668572 |
NPI Enumeration Date: | 10/03/2005 |
NPI Last Update Date: | 01/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PS004871L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |