MR. COYO BURCIAGA (NPI# 1053451062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053451062 |
| Entity Type | Individual |
| Full Name | MR. COYO BURCIAGA |
| Credential | PT |
| Practice Address |
1126 N Grand Ave Ste D Pacific Clinics Covina CA 91724-1552 |
| Practice Telephone | 6269671667 |
| Practice Fax Number | 6263319641 |
| Mailing Telephone | 6269671667 |
| Mailing Fax Number | 6263319641 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT 30761 | CA | Nursing Service Providers |
| Street Address |
1126 N GRAND AVE STE D PACIFIC CLINICS |
| City | COVINA |
| State | CA |
| Zip Code | 91724-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619595931 | Ashley Rae Garcia | Student in an Organized Health Care Education/Training Program | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2020-07-13 |
| 1457728933 | Desiree Jimenez | Counselor | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2015-08-31 |
| 1033450218 | Russell James Delgado | Counselor | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2013-03-12 |
| 1457669384 | David Jose Quinteros | Social Worker | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2010-09-14 |
| 1750697231 | Angelica Maria Fernandez | Counselor | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2010-08-23 |
| 1144465188 | George David Silva | Counselor | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2008-12-04 |
| 1679738496 | Maria Rincon | Rehabilitation Practitioner | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2008-07-21 |
| 1679740682 | Jennifer Woolery | Rehabilitation Practitioner | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2008-05-09 |
| 1811160005 | Deborah Armine Henderson | Rehabilitation Practitioner | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2008-04-08 |
| 1407053382 | Jerrence Owens | Counselor | 1126 N Grand Ave Ste D, Covina, CA 91724-1552 | 2007-07-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902320922 | Kimberly Suzanne Manzanares-mora | Rehabilitation Practitioner | 1359 North Grand Avenue, Covina, CA 91724 | 2017-08-01 |
| 1689194680 | Cynthia Garcia | Counselor | 1359 N. Grand Ave., Covina, CA 91724 | 2017-06-21 |
| 1386191963 | West Covina Group Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1274 Center Court Dr, #208, Covina, CA 91724 | 2016-09-01 |
| 1184094781 | Veronica May Roberts | Licensed Vocational Nurse | 222 S. Wilson Ave, Covina, CA 91724 | 2015-09-25 |
| 1912216292 | Joan Mendoza | Social Worker | 1338 Center Court Dr Ste 107, Covina, CA 91724 | 2010-10-04 |
| 1548583602 | Lille-anne Nzeribe | Rehabilitation Practitioner | 1126 N. Grand Ave. Suite D, Covina, CA 91724 | 2010-03-03 |
| 1154534212 | Verna L Lewis | Marriage & Family Therapist | 420 South Grand Ave., Covina, CA 91724 | 2007-05-07 |
| 1093937310 | Heather Annn Pedevillano | Specialist/Technologist | 1805 E. Lomira Dr, Covina, CA 91724 | 2007-05-03 |
| 1669503579 | Maritza Mercedes Reyes | Rehabilitation Practitioner | 1411 N. Grand Ave., Covina, CA 91724 | 2007-03-09 |
| 1417014085 | Bernadette Luyun Guaring Bagay | Dentist | 984 E Badillo St, Suite E, Covina, CA 91724 | 2007-01-03 |
| Find all providers in zip 91724 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932360104 | Ze Chavarria | Licensed Psychiatric Technician | 334 E Puente St, Covina, CA 91723 | 2008-06-20 |
| 1124201397 | Rose Marie Delgado | Licensed Psychiatric Technician | 4931 N Brightview Dr, Covina, CA 91722-2116 | 2007-12-11 |
| 1548398308 | Kory Leann Mcdonald | Licensed Psychiatric Technician | 508 S 2nd Ave, Covina, CA 91723-3012 | 2007-03-01 |
| 1578651469 | Maria E Altamirano | Licensed Psychiatric Technician | 1147 E Wingate St, Covina, CA 91724-2503 | 2006-10-10 |
| 1770113409 | Carlos Brito | Licensed Psychiatric Technician | 1161 E Covina Blvd, Covina, CA 91724-1523 | 2020-01-22 |
| 1417591579 | Mario A Ventura | Licensed Psychiatric Technician | 508 S 2nd Ave, Covina, CA 91723-3012 | 2019-11-01 |
| 1144879370 | Ismael L. Ramirez | Licensed Psychiatric Technician | 4740 N Grand Ave, Covina, CA 91724-2005 | 2019-09-10 |
| 1649835885 | Griselda Venezian | Licensed Psychiatric Technician | 508 S 2nd Ave, Covina, CA 91723-3012 | 2019-05-02 |
| 1134784531 | Brittany Kersey | Licensed Psychiatric Technician | 508 S 2nd Ave, Covina, CA 91723-3012 | 2019-05-01 |
| 1750849295 | Sylvia Arias | Licensed Psychiatric Technician | 4740 N Grand Ave, Covina, CA 91724-2005 | 2019-03-04 |
| Find all providers in COVINA | ||||
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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.