Basic Information
| Provider Information | |||||||||
| NPI: | 1912217001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAZE | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 639 BAILEY CIR | ||||||||
| Address2: | |||||||||
| City: | PAPILLION | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680464352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802968847 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7100 W CENTER RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802968847 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2010 | ||||||||
| LastUpdateDate: | 01/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 1075 | NE | Y | Behavioral Health & Social Service Providers | Psychologist | 103G00000X | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.