MS. DENISE BLACK (NPI# 1194029371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194029371 |
| Entity Type | Individual |
| Full Name | MS. DENISE BLACK |
| Practice Address |
327 College Ave Santa Rosa CA 95401-5117 |
| Practice Telephone | 7075682800 |
| Practice Fax Number | 7075682804 |
| Mailing Telephone | 7075682800 |
| Mailing Fax Number | 7075682804 |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT35099 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376851246 | Denise Lee Black | Occupational Therapy Assistant | 389 Green Street, Lockport, NY 14094 | 2010-09-14 |
| 1598304875 | Denise C Black | Physical Therapist | 700 White Plains Rd, Scarsdale, NY 10583-5063 | 2020-01-03 |
| 1871907535 | Denise Michelle Black | Counselor | 6555 Abercorn St, Suite 221, Savannah, GA 31405-5713 | 2014-06-20 |
| 1376770628 | Denise Sylvia Black | Student in an Organized Health Care Education/Training Program | 2500 Metrohealth Drive, Cleveland, OH 44109 | 2009-06-14 |
| 1477604494 | Denise R Black | Social Worker | 3495 Piedmont Road Ne I, Department of Behavioral Health, Atlanta, GA 30305 | 2007-01-16 |
| Street Address |
327 COLLEGE AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-5117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477632453 | James R Kennedy | Psychiatry & Neurology | 327 College Ave, Santa Rosa, CA 95401-5117 | 2006-11-02 |
| 1558975169 | Nebiyou Almaw Amshalu | Licensed Psychiatric Technician | 327 College Ave, Santa Rosa, CA 95401-5117 | 2020-09-01 |
| 1902444664 | Hailey Jean Mason | Community Health Worker | 327 College Ave, Santa Rosa, CA 95401-5117 | 2019-12-12 |
| 1457999286 | Irma Martinez | Licensed Psychiatric Technician | 327 College Ave, Santa Rosa, CA 95401-5117 | 2019-12-11 |
| 1003459181 | Megan Gordon | Licensed Psychiatric Technician | 327 College Ave, Santa Rosa, CA 95401-5117 | 2019-10-22 |
| 1689234684 | Sheila Kirven | Case Manager/Care Coordinator | 327 College Ave, Santa Rosa, CA 95401-5117 | 2019-06-20 |
| 1154806263 | Alison Van De Hei | Social Worker | 327 College Ave, Santa Rosa, CA 95401 | 2018-09-25 |
| 1366923914 | Alyssa Fraijo | Counselor | 327 College Ave, Santa Rosa, CA 95401-5117 | 2018-08-22 |
| 1770076705 | Kimberly Marcy | Counselor | 327 College Ave, Santa Rosa, CA 95401-5117 | 2018-06-13 |
| 1528567062 | Kevin Bley | Counselor | 327 College Ave, Santa Rosa, CA 95401-5117 | 2018-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| 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 |
|---|---|---|---|---|
| 1184171134 | Ibrahim Keita | Licensed Psychiatric Technician | 2148 Slater St, Santa Rosa, CA 95404-2428 | 2016-09-07 |
| 1306246889 | Yazmin Ruiz | Licensed Psychiatric Technician | 1901 Cleveland Avenue, Suite B, Santa Rosa Treatment Program, Santa Rosa, CA 95403 | 2014-09-03 |
| 1558975169 | Nebiyou Almaw Amshalu | Licensed Psychiatric Technician | 327 College Ave, Santa Rosa, CA 95401-5117 | 2020-09-01 |
| 1457999286 | Irma Martinez | Licensed Psychiatric Technician | 327 College Ave, Santa Rosa, CA 95401-5117 | 2019-12-11 |
| 1003459181 | Megan Gordon | Licensed Psychiatric Technician | 327 College Ave, Santa Rosa, CA 95401-5117 | 2019-10-22 |
| 1063977460 | Gardner Carlson | Licensed Psychiatric Technician | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2019-02-10 |
| 1285185819 | Bruce Black | Licensed Psychiatric Technician | 2225 Challenger Way, Santa Rosa, CA 95407 | 2016-10-19 |
| 1477926194 | Andrea Yvonne Quintana I | Licensed Psychiatric Technician | 1901 Cleveland Ave Ste B, Santa Rosa, CA 95401-4298 | 2015-11-03 |
| 1851644371 | Amanda Johanna Menary | Licensed Psychiatric Technician | 1901 Cleveland Ave, Santa Rosa, CA 95401-4282 | 2012-10-22 |
| 1679892939 | Linda Marie Bertolini | Licensed Psychiatric Technician | 1901 Cleveland Ave Ste B, Santa Rosa, CA 95401-4298 | 2010-05-26 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
Please comment or provide details below to improve the information on MS. DENISE BLACK.
| 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.