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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 167G00000X | Licensed Psychiatric Technician | 37848 | CA | Nursing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | KAISER PERMANENTE | 16127819 | 01 |
Street Address |
4987 SPEAK LN |
City | SAN JOSE |
State | CA |
Zip Code | 95118-2767 |
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 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 |
---|---|---|---|---|
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 |
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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.