JENNIFER LISA MADRID (NPI# 1578912481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578912481 |
| Entity Type | Individual |
| Full Name | JENNIFER LISA MADRID |
| Practice Address |
574 Formschlag Ln Penngrove CA 94951-8715 |
| Practice Telephone | 7073222018 |
| Mailing Telephone | 7073222018 |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT34767 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619489200 | Jennifer Madrid | Behavior Technician | 1112 Bennington St, East Boston, MA 02128-1236 | 2017-11-03 |
| 1790398485 | Jennifer Madrid | Behavior Technician | 12276 San Jose Blvd Ste 508, Jacksonville, FL 32223-8618 | 2020-08-24 |
| 1386984870 | Jennifer Ranae Madrid | Case Manager/Care Coordinator | 711 Barnes Ave, La Junta, CO 81050 | 2013-02-21 |
| Street Address |
574 FORMSCHLAG LN |
| City | PENNGROVE |
| State | CA |
| Zip Code | 94951-8715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639783848 | Christina N Wallace | Massage Therapist | 308 Oak Street, Penngrove, CA 94951 | 2020-09-04 |
| 1922126689 | Regina Ann Wilson-seppa | Specialist | 730 Goodwin Ave, Penngrove, CA 94951-8623 | 2007-03-27 |
| 1740673748 | Alexander Edward Perrotti | Marriage & Family Therapist | 3450 Lichau Rd, Penngrove, CA 94951-8720 | 2015-03-15 |
| 1053382911 | Robert Rowen Herzog | Physical Therapist | 8690 Petaluma Hill Rd, Penngrove, CA 94951-8734 | 2006-01-30 |
| 1467416743 | Donald Minor | Specialist | 4960 Rebecca Dr, Penngrove, CA 94951-9519 | 2006-04-13 |
| 1689080194 | Edward Rosen | Physical Therapist | 6575 Eagle Ridge Rd, Penngrove, CA 94951-9575 | 2014-07-03 |
| 1083112221 | Kimberly Ann Brasil | Dental Hygienist | 9663 Old Redwood Hwy, Penngrove, CA 94951-9610 | 2018-01-23 |
| 1356458541 | Alexandra Advocate | Marriage & Family Therapist | 10864 Minnesota Ave, Penngrove, CA 94951-9617 | 2006-08-24 |
| 1043628829 | Stephen Smith | Counselor | 520 Orchard Ln, Penngrove, CA 94951-9659 | 2014-07-24 |
| 1144857475 | Natalie Diane Hole | Speech-Language Pathologist | 1379 Dutch Ln, Penngrove, CA 94951-9718 | 2020-03-25 |
| Find all providers in zip 94951 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.