MAIJA THACKERSON (NPI# 1346502218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346502218 |
Entity Type | Individual |
Full Name | MAIJA THACKERSON |
Credential | L.P.T. |
Practice Address |
4151 E Fountain St Long Beach CA 90804-3023 |
Practice Telephone | 5627199250 |
Practice Fax Number | 5627199261 |
Enumeration Date | 2012-06-15 |
Last Update Date | 2012-06-15 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 167G00000X | Licensed Psychiatric Technician | PT 16398 | CA | Nursing Service Providers |
Street Address |
4151 E FOUNTAIN ST |
City | LONG BEACH |
State | CA |
Zip Code | 90804-3023 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427185917 | Childnet Youth and Family Services Inc | Community/Behavioral Health | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2007-02-28 |
1184005050 | Alexsa Wicker | Marriage & Family Therapist | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2015-06-16 |
1417350125 | Eric Lamar Williams Jr. | Case Manager/Care Coordinator | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2014-10-08 |
1053720235 | Ruya Urso | Marriage & Family Therapist | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2014-08-12 |
1235544586 | Ammar Ali Altowaiji | Marriage & Family Therapist | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2014-06-25 |
1972928190 | Ashley Dunn | Marriage & Family Therapist | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2014-02-25 |
1427484872 | Monique Palmer | Case Manager/Care Coordinator | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2013-09-17 |
1336574938 | Brittany L. Giordano | Marriage & Family Therapist | 4151 E Fountain St, Long Beach, CA 90804 | 2013-09-13 |
1528307378 | Ruqayyah Samia | Marriage & Family Therapist | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2013-02-13 |
1770822025 | Aziza Hunter | Case Manager/Care Coordinator | 4151 E Fountain St, Long Beach, CA 90804-3023 | 2013-02-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821616673 | Exporter Medical LLC | Durable Medical Equipment & Medical Supplies | 2990 E. Pacific Coast Hwy., Suite B, Long Beach, CA 90804 | 2020-07-08 |
1700436094 | Magdalema Ballesteros-reynolds | Technician | 844 Ohio Ave, Long Beach, CA 90804 | 2019-09-18 |
1093365447 | Edelmira D Sanchez | Technician | 837 Bennett Ave, Long Beach, CA 90804 | 2019-09-18 |
1164980165 | Carlton Fortenberry | Behavior Technician | 775 Obispo Ave., Unit 1, Long Beach, CA 90804 | 2019-03-08 |
1427522812 | Western Dental Services, Inc. | Dentist | 2306 E 7th Street, Long Beach, CA 90804 | 2019-01-18 |
1124557657 | Keav Siv Khov | Social Worker | 4510 East Pacific Coast Highway, Suite 600, Long Beach, CA 90804 | 2017-06-08 |
1265966576 | Kensie Hoag | Social Worker | 4510 E PCh, Suite 305, Long Beach, CA 90804 | 2017-04-13 |
1528424389 | Rem Pacific Sleep Center, Inc. | Specialist/Technologist | 2990 E. Pacific Coast Hwy, Suite A, Long Beach, CA 90804 | 2016-01-10 |
1417326935 | Kelli Ann Carlson | Student in an Organized Health Care Education/Training Program | 2025 E. 7th Street, Long Beach, CA 90804 | 2015-09-15 |
1487059010 | Kenenth K. Lee, D.d.s., Inc. | Preferred Provider Organization | 4755 E. Anaheim St., Long Beach, CA 90804 | 2014-10-24 |
Find all providers in zip 90804 |
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 |
---|---|---|---|---|
1821450016 | Ryann Thibodeaux | Licensed Psychiatric Technician | 2385 Easy Ave, Long Beach, CA 90810-3334 | 2016-03-25 |
1417047069 | Anthony Desanto-kelly | Licensed Psychiatric Technician | 3501 N Lakewood Blvd, Long Beach, CA 90808-1736 | 2006-10-13 |
1730793563 | Perla Hernandez | Licensed Psychiatric Technician | 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 | 2020-08-31 |
1740893916 | Lisa Louise Morrison | Licensed Psychiatric Technician | 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 | 2020-08-27 |
1114539921 | Maria Barnes | Licensed Psychiatric Technician | 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 | 2020-08-21 |
1831701267 | Craig Alexander March | Licensed Psychiatric Technician | 1501 Hughes Way Ste 100, Long Beach, CA 90810-1877 | 2020-08-18 |
1548878606 | Alejandro Chavira | Licensed Psychiatric Technician | 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 | 2020-07-15 |
1235773045 | Parchae Heard | Licensed Psychiatric Technician | 456 Elm Ave, Long Beach, CA 90802-2426 | 2019-11-05 |
1962044206 | Davinesha Marie Sally | Licensed Psychiatric Technician | 1775 Chestnut Ave, Long Beach, CA 90813-1674 | 2019-10-08 |
1295388684 | Vincent Lopez | Licensed Psychiatric Technician | 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 | 2019-07-24 |
Find all providers in LONG BEACH |
City | LONG BEACH |
Zip Code | 90804 |
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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.