KATHLEEN GRUNBAUM JOHNSON (NPI# 1801314158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801314158 |
| Entity Type | Individual |
| Full Name | KATHLEEN GRUNBAUM JOHNSON |
| Other Name | KATHLEEN THERESA GRUNBAUM |
| Practice Address |
902 S Myrtle Ave Monrovia CA 91016-1765 |
| Mailing Address |
902 S Myrtle Ave Monrovia CA 91016-3427 |
| Practice Telephone | (626) 357-3258 |
| Practice Fax Number | 6263030529 |
| Mailing Telephone | 6263573258 |
| Mailing Fax Number | 6263030529 |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2017-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT32661 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1083129613 | Kathleen Yezek Johnson | Speech-Language Pathologist | 4700 School Rd, Ringwood, IL 60072-9606 | 2017-12-05 |
| 1366966616 | Kathleen M Johnson | Registered Nurse | 3525 W Oxford Ave Unit G-2, Denver, CO 80236-3114 | 2017-07-28 |
| 1912433889 | Kathleen Johnson | Dietitian, Registered | 1635 Belt St, Baltimore, MD 21230-4705 | 2017-05-11 |
| 1700214392 | Kathleen Johnson | Nurse Practitioner | 30 E Huron St Apt 1002, Chicago, IL 60611-2742 | 2013-10-17 |
| 1942541503 | Kathleen Anne Johnson | Speech-Language Pathologist | 841 N Downs St Ste C, Ridgecrest, CA 93555-3380 | 2013-03-07 |
| 1386922441 | Kathleen O'hara Johnson | Internal Medicine | 6330 Riverdale Rd, Riverdale, GA 30274-1617 | 2011-07-23 |
| 1124310198 | Kathleen Theresa Johnson | Nurse Practitioner | 113 N Campbell Rd, Royal Oak, MI 48067-2345 | 2011-05-10 |
| 1497071641 | Kathleen Johnson | Adult Companion | 208 Maple St., Apt. 208, Big Rapids, MI 49307 | 2010-04-13 |
| 1710165360 | Kathleen Mcgraw Johnson | Social Worker | 22800 Golfview Dr, Southfield, MI 48033-6648 | 2008-02-06 |
| Street Address |
902 S MYRTLE AVE |
| City | MONROVIA |
| State | CA |
| Zip Code | 91016-1765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447360730 | Pacific Clinics | Community/Behavioral Health | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2006-08-30 |
| 1871109025 | Carrie Kathleen Reynolds | Counselor | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2020-09-22 |
| 1861000622 | Bethany Grace Ferguson | Rehabilitation Counselor | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2020-07-17 |
| 1528683745 | Lisa Michelle Rahm | Student in an Organized Health Care Education/Training Program | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2020-06-12 |
| 1932730454 | Ezra Robert Nordin Dureault | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2020-02-03 |
| 1063059681 | Erlinda Uribe | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016 | 2019-12-02 |
| 1124662994 | Dominic Gerald Villanueva | Counselor | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2019-11-04 |
| 1215571484 | Lisa Donerson | Licensed Vocational Nurse | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2019-10-31 |
| 1912541301 | Marian Girgis | Counselor | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2019-10-30 |
| 1558923029 | Sahran Abena Hamit | Rehabilitation Counselor | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2019-07-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659914166 | Cynthia Marie Garcia | Behavior Technician | 612 S. Myrtle Ave., Suite 100, Monrovia, CA 91016 | 2019-10-28 |
| 1366096232 | Richard Compton Lamb | Health Educator | 825 S Myrtle Avenue, Monrovia, CA 91016 | 2019-07-30 |
| 1487208450 | Brendan Mai | Behavioral Analyst | 200 W Atara St, Monrovia, CA 91016 | 2019-07-29 |
| 1124672035 | Kathleen Marie Novell | Speech-Language Pathologist | 168 Poinsettia Avenue, Monrovia, CA 91016 | 2019-07-29 |
| 1932675931 | Rainbow Home Inc | Clinic/Center | 917 Monrovista Ave, Unit A, Monrovia, CA 91016 | 2018-10-17 |
| 1386136398 | Anh Van Ly | Physician Assistant | 116 W. Lime Ave, Monrovia, CA 91016 | 2018-06-05 |
| 1447741160 | Vera Lucia Mayorga | Licensed Psychiatric Technician | 816 Bonita St Apt B, Monrovia, CA 91016 | 2018-05-29 |
| 1518484146 | Carolyn Ann Burns | Home Health Aide | 1321 Orange Ave, Monrovia, CA 91016 | 2017-08-24 |
| 1962924357 | Ariela Ettie Emery | Genetic Counselor, MS | 655 East Huntington Drive, Monrovia, CA 91016 | 2017-07-07 |
| 1427578624 | Rebecca Niole Leal | Marriage & Family Therapist | 507 W Foothill Blvd, Monrovia, CA 91016 | 2017-06-20 |
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| 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 |
|---|---|---|---|---|
| 1447741160 | Vera Lucia Mayorga | Licensed Psychiatric Technician | 816 Bonita St Apt B, Monrovia, CA 91016 | 2018-05-29 |
| 1932730454 | Ezra Robert Nordin Dureault | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2020-02-03 |
| 1063059681 | Erlinda Uribe | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016 | 2019-12-02 |
| 1578932232 | Tania Paola Ortiz-arreola | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2015-09-23 |
| 1992050884 | Tonya Brandon | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2012-07-17 |
| 1558643080 | Joana Rincon | Licensed Psychiatric Technician | 2620 S California Ave, Monrovia, CA 91016-5026 | 2011-09-10 |
| 1538303300 | Olufunke Folasade Alade-chester | Licensed Psychiatric Technician | 902 S Myrtle Ave, Monrovia, CA 91016-3427 | 2009-04-23 |
| 1720126378 | Samantha Elizabeth James-perez | Licensed Psychiatric Technician | 902 S Myrtle Ave, 1st Floor, Monrovia, CA 91016-3427 | 2007-02-02 |
| 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 |
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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.