TABITHA WAMBAA (NPI# 1053962480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053962480 |
| Entity Type | Individual |
| Full Name | TABITHA WAMBAA |
| Practice Address |
115 E Fesler St Santa Maria CA 93454-4404 |
| Practice Telephone | 8059226597 |
| Mailing Telephone | 8059226597 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 41099 | CA | Nursing Service Providers |
| Street Address |
115 E FESLER ST |
| City | SANTA MARIA |
| State | CA |
| Zip Code | 93454-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003972654 | Aegis Treatment Centers, LLC | Clinic/Center | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2006-12-28 |
| 1528601002 | Mia Alexander | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2019-10-28 |
| 1053962969 | James Owen Fitzmaurice | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2019-09-23 |
| 1437705696 | Linda Platt Mintz | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2019-08-14 |
| 1447816434 | Dwayne Franklin Newman | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2019-05-15 |
| 1457823643 | Evan Joseph Dougherty | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2018-12-28 |
| 1053881383 | Mark Bocock | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2018-11-29 |
| 1629547799 | Benjamin Aguayo | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2018-11-19 |
| 1255806709 | Veronica Dominguez | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2018-10-11 |
| 1487140943 | Stacey Lou Valdez | Counselor | 115 E Fesler St, Santa Maria, CA 93454-4404 | 2018-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995825 | Virgilia Elizabeth Kennedy | Counselor | 1505 Shepard Drive, Suite 204, Santa Maria, CA 93454 | 2019-01-05 |
| 1891290151 | Philbert Ramirez Pandac | Behavioral Analyst | 1016 East Maint Street, Santa Maria, CA 93454 | 2018-03-28 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| 1306357892 | Aklilu Joseph | Pharmacist | 1700 S. Bradley Rd, Santa Maria, CA 93454 | 2017-10-24 |
| 1225557267 | Eric Edward Lofstrand | Counselor | 1214 S Miller St Ste 11, Santa Maria, CA 93454 | 2017-09-11 |
| 1881112449 | Tess Wianecki | Physician Assistant | 116 S Palisade Dr Ste 110, Santa Maria, CA 93454 | 2017-09-05 |
| 1730603705 | Cac Alvin Center | Counselor | 316 E Mcelhany Ave, Santa Maria, CA 93454 | 2017-08-01 |
| 1174045009 | Peter A. Statti Md Inc. | Pediatrics | 1414 S. Miller St. #12, Santa Maria, CA 93454 | 2017-07-12 |
| 1982143970 | Child Abuse Listening Mediation | Community/Behavioral Health | 210 E. Enos Dr., Ste. A, Santa Maria, CA 93454 | 2017-02-23 |
| 1821531344 | Maria Isabel Lara | Counselor | 210 E Enos Dr, Santa Maria, CA 93454 | 2016-12-01 |
| Find all providers in zip 93454 | ||||
| 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 |
|---|---|---|---|---|
| 1316440753 | Chastity Lynn O'brien | Licensed Psychiatric Technician | 1836 Alhambra Ave, Santa Maria, CA 93458-8337 | 2018-03-12 |
| 1891151577 | Lauren Frushon | Licensed Psychiatric Technician | 2057 Mariah Dr, Santa Maria, CA 93454-5521 | 2016-01-11 |
| 1326111360 | Deneice Tell | Licensed Psychiatric Technician | 124 Carmen Ln Ste K, Santa Maria, CA 93458-7768 | 2006-11-16 |
| 1184236622 | Richelle Rose Aguirre | Licensed Psychiatric Technician | 212 Carmen Ln Ste 201, Santa Maria, CA 93458-7771 | 2020-08-17 |
| 1508404260 | Ruby Akowuah | Licensed Psychiatric Technician | 116 Agnes Ave, Santa Maria, CA 93458-2838 | 2019-12-12 |
| 1801448659 | Lacey Marie Hemeon | Licensed Psychiatric Technician | 212 Carmen Ln Ste 201, Santa Maria, CA 93458-7771 | 2019-07-11 |
| 1639665284 | Veronica Dobrick | Licensed Psychiatric Technician | 116 Agnes Ave, Santa Maria, CA 93458-2838 | 2018-07-06 |
| 1770085334 | Peter Joseph Curto II | Licensed Psychiatric Technician | 124 Carmen Ln Ste A, Santa Maria, CA 93458 | 2018-02-28 |
| 1427565605 | Kimberly Denise Cattaneo | Licensed Psychiatric Technician | 117 W Tunnell St, Santa Maria, CA 93458-4096 | 2018-01-09 |
| 1437698362 | Lauro L Garcia | Licensed Psychiatric Technician | 212 Carmen Ln Ste 201, Santa Maria, CA 93458-7771 | 2017-02-12 |
| Find all providers in SANTA MARIA | ||||
| City | SANTA MARIA |
| Zip Code | 93454 |
Please comment or provide details below to improve the information on TABITHA WAMBAA.
| 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.