MS. VICTORIA LYNN BROUSSARD (NPI# 1770624090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770624090 |
Entity Type | Individual |
Full Name | MS. VICTORIA LYNN BROUSSARD |
Credential | LPT |
Practice Address |
4600 Bresee Ave Baldwin Park CA 91706-2414 |
Practice Telephone | 6263370747 |
Mailing Telephone | 6263370747 |
Enumeration Date | 2007-02-09 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 167G00000X | Licensed Psychiatric Technician | 19904 | CA | Nursing Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689213126 | Victoria Broussard | Behavior Technician | 12432 Bellflower Blvd, Downey, CA 90242-2806 | 2020-01-02 |
1568939585 | Victoria Burger Broussard | Physical Therapist | 2579 Eric Ln Ste K, Burlington, NC 27215-5416 | 2018-10-29 |
1275012114 | Victoria Noel Broussard | Occupational Therapist | 1810 Old Granger, Taylor, TX 76574-3564 | 2018-08-10 |
Street Address |
4600 BRESEE AVE |
City | BALDWIN PARK |
State | CA |
Zip Code | 91706-2414 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588206700 | Sistine Manor Inc | Assisted Living Facility | 12755 Torch St, Baldwin Park, CA 91706 | 2019-10-09 |
1891268850 | Rodriguez Cruz Dental, Inc. | Clinic/Center | 14323 Ramona Blvd., Baldwin Park, CA 91706 | 2019-01-02 |
1942788633 | Desiree Montoya | Counselor | 13030 Ramona Blvd Unit 65, Baldwin Park, CA 91706 | 2018-08-03 |
1861978215 | Cassidy Alyse Harton | Counselor | 4514 Grace Ave, Baldwin Park, CA 91706 | 2018-07-18 |
1881146751 | Melissa Valenzuela | Nurse Practitioner | 14362 E. Ramona Blvd, Baldwin Park, CA 91706 | 2016-10-26 |
1629524228 | Trosclair Seals | Counselor | 36 S Kinneola Ave, Pasad, CA 91706 | 2016-09-01 |
1487025854 | Janeth Estevez | Case Manager/Care Coordinator | 14123 Masline St, Baldwin Park, CA 91706 | 2015-10-12 |
1932579570 | Bls Dental Group | Clinic/Center | 14032 Ramona Blvd., Bladwin Park, CA 91706 | 2015-09-25 |
1487068748 | Prakash P. Patel D.ds Inc | Dentist | 4138 N. Maine Ave, Suite N-3, Baldwin Park, CA 91706 | 2014-06-16 |
1295076891 | Julia Lauria | Rehabilitation Practitioner | 11317 Rmaona Blvd., Ste.c, Irwindale, CA 91706 | 2013-03-06 |
Find all providers in zip 91706 |
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 |
---|---|---|---|---|
1871822254 | Araceli Osorio | Licensed Psychiatric Technician | 13721 Foster Ave, Baldwin Park, CA 91706 | 2009-12-15 |
1376790444 | Jacob Lee Taylor | Licensed Psychiatric Technician | 13716 Monterey Ave, Baldwin Park, CA 91706-4057 | 2008-08-20 |
1659406577 | Annette Marie Perry | Licensed Psychiatric Technician | 3915 Center St, Apt C, Baldwin Park, CA 91706-2918 | 2007-02-22 |
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 |
City | BALDWIN PARK |
Zip Code | 91706 |
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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.