MS. ALEXIS VICTORIA MOULTON (NPI# 1962593616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962593616 |
| Entity Type | Individual |
| Full Name | MS. ALEXIS VICTORIA MOULTON |
| Practice Address |
1300 S Grand Ave Ste C Santa Ana CA 92705-4402 |
| Practice Telephone | 7145677634 |
| Mailing Telephone | 7145677688 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT24746 | CA | Nursing Service Providers |
| Street Address |
1300 S GRAND AVE STE C |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92705-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629532874 | Jennifer Tracy Lesser | Registered Nurse | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2019-01-22 |
| 1669857710 | Ana Rosa Melendez | Counselor | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4402 | 2015-07-29 |
| 1962807727 | Cristina Madory | Social Worker | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2014-10-22 |
| 1932410925 | Edwin Alexander Cruz | Counselor | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4402 | 2010-06-24 |
| 1477723856 | Brett David Williams | Case Manager/Care Coordinator | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2008-03-03 |
| 1841469103 | Ithamar Young | Case Manager/Care Coordinator | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2008-02-20 |
| 1881862795 | Monique Rochelle Nilsen | Case Manager/Care Coordinator | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2008-02-13 |
| 1326226705 | John C. Claxton | Case Manager/Care Coordinator | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2008-02-07 |
| 1265610687 | Kelly Weaver | Case Manager/Care Coordinator | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2008-02-07 |
| 1063690444 | Darren Anthony Tan | Case Manager/Care Coordinator | 1300 S Grand Ave Ste C, Santa Ana, CA 92705-4434 | 2008-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952919763 | John G. Alevizos, D.o., A Professional Medical Corporation | Preventive Medicine | 1530 East Edinger Avenue, Suite 1, Santa Ana, CA 92705 | 2020-07-17 |
| 1477186625 | Joyce Altman Interpreters, Inc. | Interpreter | 1971 East 4th Street, Ste 206, Santa Ana, CA 92705 | 2020-02-17 |
| 1588214688 | Cindy Mejia | Behavior Technician | 505 N. Tustin Ave., #152, Santa Ana, CA 92705 | 2019-09-19 |
| 1588210504 | Jennifer Ang Lim-quevedo | Nurse Practitioner | 18362 Whitney Dr, Santa Ana, CA 92705 | 2019-08-15 |
| 1962056820 | Melinda Acosta Black | Social Worker | 1526 Brookhollow Drive, Santa Ana, CA 92705 | 2019-07-30 |
| 1972069631 | Amy Marie Elit | Nurse Practitioner | 1751 E Harry Ave, Santa Ana, CA 92705 | 2019-02-18 |
| 1386118180 | Unified Behavioral Health, LLC | Substance Abuse Rehabilitation Facility | 1218 W Santa Ana Blvd, Santa Ana, CA 92705 | 2019-01-15 |
| 1952884736 | Javier Perales | Social Worker | 1652 Windsor Ln, Santa Ana, CA 92705 | 2018-09-08 |
| 1073009700 | Eva E Kuncewicki | Marriage & Family Therapist | 1001 S Grand Ave # B, Santa Ana, CA 92705 | 2018-07-05 |
| 1487149886 | Nimbus Medtransport Inc. | Non-emergency Medical Transport (VAN) | 2112 E 4th St Ste 235, Santa Ana, CA 92705 | 2018-06-27 |
| Find all providers in zip 92705 | ||||
| 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 |
|---|---|---|---|---|
| 1184722316 | Jason Russel D'amico | Licensed Psychiatric Technician | 1300 S Grand Ave, Santa Ana, CA 92705-4434 | 2006-09-20 |
| 1912504531 | Jorge Alejandro Sanchez Delgado | Licensed Psychiatric Technician | 1207 E Fruit St, Santa Ana, CA 92701-4296 | 2020-10-06 |
| 1730796822 | Beth Anne Gayle Greenberg | Licensed Psychiatric Technician | 1200 N Main St Ste 300, Santa Ana, CA 92701-3625 | 2020-09-23 |
| 1710596648 | Manuel Ramone Ferdinand Jr. | Licensed Psychiatric Technician | 1910 N Bush St, Santa Ana, CA 92706-2816 | 2020-07-27 |
| 1780146852 | Angelina Terese Lucero | Licensed Psychiatric Technician | 2100 N Broadway Ste 101, Santa Ana, CA 92706-2624 | 2019-04-05 |
| 1598259632 | Vernon Leslie Castle | Licensed Psychiatric Technician | 1030 W Warner Ave, Santa Ana, CA 92707-3147 | 2018-06-21 |
| 1265698708 | Vanessa M Mccreery | Licensed Psychiatric Technician | 2130 E 4th St Ste 200, Santa Ana, CA 92705-3818 | 2008-08-04 |
| 1003905167 | Maria Del Refugio Rivera Ruiz | Licensed Psychiatric Technician | 1200 N Main St, Suite # 890, Santa Ana, CA 92701-3640 | 2006-10-12 |
| 1518068915 | Laura E. Villegas Perdomo | Licensed Psychiatric Technician | 405 W 5th St, Ste 212, Santa Ana, CA 92701-4519 | 2006-09-26 |
| 1144327842 | Lynette Dee Ewing | Licensed Psychiatric Technician | 1030 W Warner Ave, Santa Ana, CA 92707-3147 | 2006-09-17 |
| Find all providers in SANTA ANA | ||||
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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.