MR. BRIAN SCOTT PENDLEBERRY (NPI# 1467586214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467586214 |
| Entity Type | Individual |
| Full Name | MR. BRIAN SCOTT PENDLEBERRY |
| Credential | LPT |
| Practice Address |
1722 S Lewis Rd Camarillo CA 93012-8520 |
| Mailing Address |
307 Charro Ave Thousand Oaks CA 91320-3658 |
| Practice Telephone | 8054457800 |
| Practice Fax Number | 8054457830 |
| Mailing Telephone | 8056303101 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT24244 | CA | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LICENSE | PT24244 | 01 |
| Street Address |
1722 S LEWIS RD |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93012-8520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093705915 | Danielle Shaw | Pediatrics | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2005-10-22 |
| 1588262455 | Tiai Kelvin Salanoa | Case Manager/Care Coordinator | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-10-13 |
| 1891300018 | Michelle Marie Vrkljan | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-09-14 |
| 1255946471 | Tatiana Pinkley | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-09-14 |
| 1346855897 | Jose Jesus Martinez | Case Manager/Care Coordinator | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-09-11 |
| 1215540406 | Amanda Swezey | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-08-26 |
| 1689285553 | Adrian Rodriguez-cruz | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-08-13 |
| 1043820921 | Jaclyn Wolf | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-08-05 |
| 1144830068 | Greta Hilbrands | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-08-05 |
| 1609486638 | Sherry Paden | Counselor | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322895 | Natasha Nichole Johnson | Licensed Vocational Nurse | 1750 A S Lewis Rs, Camarillo, CA 93012 | 2020-06-26 |
| 1609392604 | Dain Emmanuel Acevedo | Counselor | 5284 Adolfo Road Suite 100, Camarillo, CA 93012 | 2017-08-21 |
| 1679093751 | Emily Sophia Rodriguez | Counselor | 5284 Adolfo Rd. Suite 100, Camarillo, CA 93012 | 2017-06-21 |
| 1164952750 | Valerie Marie Inez Rivera | Counselor | 5284 Adolfo Rd #100, Camarillo, CA 93012 | 2017-06-15 |
| 1457890709 | Constance Walsh | Prosthetic/Orthotic Supplier | 795 Camarillo Springs Rd, Suite C, Carmarillo, CA 93012 | 2017-02-20 |
| 1902349020 | Ferdinand Fortune Cuico | Registered Nurse | 421 Brister Park Ct, Camarillo, CA 93012 | 2016-11-21 |
| 1699226795 | Lauren Streiter | Counselor | 1750b S Lewis Rd, Camarillo, CA 93012 | 2016-10-24 |
| 1972955649 | Evolve Growth Initiatives, LLC | Community Based Residential Treatment Facility, Mental Illness | 799 Camarillo Springs Road, Ventura, CA 93012 | 2016-07-06 |
| 1083075089 | Justin Rodriguez Urbano | Dental Hygienist | 4422 Corte Arbusto, Camarillo, CA 93012 | 2016-03-18 |
| 1578924619 | Leslie Winn | Counselor | 291 Camino Leon, Camarillo, CA 93012 | 2016-03-17 |
| Find all providers in zip 93012 | ||||
| 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 |
|---|---|---|---|---|
| 1891034948 | Debra Matsuye Morgan | Licensed Psychiatric Technician | 1191 Jay Ave, Camarillo, CA 93010-2828 | 2013-02-10 |
| 1932304391 | Mildred Elinore Schlimgen | Licensed Psychiatric Technician | 1954 Loma Dr, Camarillo, CA 93010-3719 | 2007-06-17 |
| 1689840449 | Rascel Datuin-intia | Licensed Psychiatric Technician | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2008-05-01 |
| 1871669044 | Jani Hamlin | Licensed Psychiatric Technician | 1722 S Lewis Rd, Camarillo, CA 93012-8520 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203592 | Leahann Vedella | Licensed Psychiatric Technician | 2398 Flatley Cir, Fairfield, CA 94533-8921 | 2020-10-23 |
| 1225635865 | Thalia I. Rochel | Licensed Psychiatric Technician | 450 E Temple St, Los Angeles, CA 90012-4022 | 2020-10-06 |
| 1427665090 | Egbert Tantiongco | Licensed Psychiatric Technician | 1460 E Willow St, Signal Hill, CA 90755-3549 | 2020-09-28 |
| 1114530250 | Heather Elizabeth Phillips | Licensed Psychiatric Technician | 4900 N Highway 99 Unit 68, Stockton, CA 95212-1007 | 2020-08-28 |
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1609491935 | Elisa Becerra | Licensed Psychiatric Technician | 745 Park St, Paso Robles, CA 93446-2834 | 2020-06-12 |
| 1518581099 | Theresa Lynn Stewart | Licensed Psychiatric Technician | 1110 Newport Way, Roseville, CA 95661-5315 | 2020-06-01 |
| 1093337511 | Christine Ann Scheuermann | Licensed Psychiatric Technician | 1447 Report Ave, Stockton, CA 95205-3030 | 2020-05-07 |
| 1477189512 | Sandra J Foshee | Licensed Psychiatric Technician | 48918 Mojave Dr, Morongo Valley, CA 92256-9243 | 2020-03-20 |
| 1376177725 | Chanel Christine Turpin | Licensed Psychiatric Technician | 450 Kings County Dr Ste 102, Hanford, CA 93230-5782 | 2020-02-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. BRIAN SCOTT PENDLEBERRY.
| 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.