MS. ISATA S MBAWA


Address: 4987 Speak Ln, San Jose, CA 95118-2767
Phone: 4084171164

MS. ISATA S MBAWA (NPI# 1346754025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346754025
Entity Type Individual
Full Name MS. ISATA S MBAWA
Credential LPT
Practice Address 4987 Speak Ln
San Jose
CA 95118-2767
Practice Telephone 4084171164
Mailing Telephone 4084171164
Enumeration Date 2017-11-16
Last Update Date 2017-11-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 167G00000X Licensed Psychiatric Technician 37848 CA Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA KAISER PERMANENTE 16127819 01

Office Location

Street Address 4987 SPEAK LN
City SAN JOSE
State CA
Zip Code 95118-2767

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235620907 Misty Henne-bhullar Dmd Inc. Dentist 4984 Cherry Ave, San Jose, CA 95118 2018-05-29
1770013096 Eunju Bang Acupuncturist 3315 Almaden Expy Ste 27, San Jose, CA 95118 2017-06-19
1306299391 Satellite Healthcare Inc Clinic/Center 1450 Kooser Road, San Jose, CA 95118 2016-07-14
1881060739 Brittany Star Curry Physical Therapist 3150 Almaden Expy Ste 120, San Jose, CA 95118 2015-08-14
1154690188 Carrie Herbst Marriage & Family Therapist 1390 Dentwood Dr, San Jose, CA 95118 2011-12-20
1104096825 Cheryl Ann Engelstad Marriage & Family Therapist 1455 E Foxworthy Ave, Pmb 159, San Jose, CA 95118 2008-03-10
1427251271 Eric John Bohl Marriage & Family Therapist 4990 Speak Ln., Suite 100, San Jose, CA 95118 2007-06-08
1326249954 Marcia May Kaufmann Social Worker 4990 Speak Lane, Suite 100, San Jose, CA 95118 2007-05-30
1386796498 Rena Jean Zahorsky Marriage & Family Therapist 4990 Speak Lane Suite 100, San Jose, CA 95118 2007-01-17
1992885883 Minoo Mehdikhan Psychologist 1131 Luchessi Dr Suite 2, San Jose, CA 95118 2006-10-16
Find all providers in zip 95118

Taxonomy Information

Taxonomy Code 167G00000X
Grouping Nursing Service Providers
Classification Licensed Psychiatric Technician

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144716705 Esmeralda Tinoco Licensed Psychiatric Technician 871 Enborg Court, San Jose, CA 95128 2018-07-06
1629512421 Godwin Kebila Kaba Licensed Psychiatric Technician 344 Los Pinos Way, San Jose, CA 95123-5117 2016-12-13
1457762767 Baltazar Pulido Licensed Psychiatric Technician 2459 Jubilee Ln, San Jose, CA 95131-1987 2014-05-08
1750404570 Jose Soliz Licensed Psychiatric Technician 277 Omira Dr, San Jose, CA 95123-3635 2007-04-08
1437756913 Juan Ramon Zago Licensed Psychiatric Technician 2221 Enborg Ln, San Jose, CA 95128-2608 2020-10-07
1851916415 Zekarias Eyassu Licensed Psychiatric Technician 1425 Fruitdale Ave, San Jose, CA 95128-3234 2020-06-10
1780207571 Andrea Hernandez Licensed Psychiatric Technician 1885 Lundy Ave Ste 223, San Jose, CA 95131-1888 2020-05-27
1700426350 Christianna Paula Mathews Licensed Psychiatric Technician 2001 The Alameda, San Jose, CA 95126-1136 2020-01-12
1376189928 Alma Valencia Chacon Licensed Psychiatric Technician 2001 The Alameda, San Jose, CA 95126-1136 2019-11-19
1295370666 Henry Thinh Duong Licensed Psychiatric Technician 2001 The Alameda, San Jose, CA 95126-1136 2019-11-08
Find all providers in SAN JOSE

Competitor

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City SAN JOSE
Zip Code 95118

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Dataset Information

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.

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