MAIJA THACKERSON


Address: 4151 E Fountain St, Long Beach, CA 90804-3023
Phone: 5627199250

MAIJA THACKERSON (NPI# 1346502218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346502218
Entity Type Individual
Full Name MAIJA THACKERSON
Credential L.P.T.
Practice Address 4151 E Fountain St
Long Beach
CA 90804-3023
Practice Telephone 5627199250
Practice Fax Number 5627199261
Enumeration Date 2012-06-15
Last Update Date 2012-06-15
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 167G00000X Licensed Psychiatric Technician PT 16398 CA Nursing Service Providers

Office Location

Street Address 4151 E FOUNTAIN ST
City LONG BEACH
State CA
Zip Code 90804-3023

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427185917 Childnet Youth and Family Services Inc Community/Behavioral Health 4151 E Fountain St, Long Beach, CA 90804-3023 2007-02-28
1184005050 Alexsa Wicker Marriage & Family Therapist 4151 E Fountain St, Long Beach, CA 90804-3023 2015-06-16
1417350125 Eric Lamar Williams Jr. Case Manager/Care Coordinator 4151 E Fountain St, Long Beach, CA 90804-3023 2014-10-08
1053720235 Ruya Urso Marriage & Family Therapist 4151 E Fountain St, Long Beach, CA 90804-3023 2014-08-12
1235544586 Ammar Ali Altowaiji Marriage & Family Therapist 4151 E Fountain St, Long Beach, CA 90804-3023 2014-06-25
1972928190 Ashley Dunn Marriage & Family Therapist 4151 E Fountain St, Long Beach, CA 90804-3023 2014-02-25
1427484872 Monique Palmer Case Manager/Care Coordinator 4151 E Fountain St, Long Beach, CA 90804-3023 2013-09-17
1336574938 Brittany L. Giordano Marriage & Family Therapist 4151 E Fountain St, Long Beach, CA 90804 2013-09-13
1528307378 Ruqayyah Samia Marriage & Family Therapist 4151 E Fountain St, Long Beach, CA 90804-3023 2013-02-13
1770822025 Aziza Hunter Case Manager/Care Coordinator 4151 E Fountain St, Long Beach, CA 90804-3023 2013-02-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821616673 Exporter Medical LLC Durable Medical Equipment & Medical Supplies 2990 E. Pacific Coast Hwy., Suite B, Long Beach, CA 90804 2020-07-08
1700436094 Magdalema Ballesteros-reynolds Technician 844 Ohio Ave, Long Beach, CA 90804 2019-09-18
1093365447 Edelmira D Sanchez Technician 837 Bennett Ave, Long Beach, CA 90804 2019-09-18
1164980165 Carlton Fortenberry Behavior Technician 775 Obispo Ave., Unit 1, Long Beach, CA 90804 2019-03-08
1427522812 Western Dental Services, Inc. Dentist 2306 E 7th Street, Long Beach, CA 90804 2019-01-18
1124557657 Keav Siv Khov Social Worker 4510 East Pacific Coast Highway, Suite 600, Long Beach, CA 90804 2017-06-08
1265966576 Kensie Hoag Social Worker 4510 E PCh, Suite 305, Long Beach, CA 90804 2017-04-13
1528424389 Rem Pacific Sleep Center, Inc. Specialist/Technologist 2990 E. Pacific Coast Hwy, Suite A, Long Beach, CA 90804 2016-01-10
1417326935 Kelli Ann Carlson Student in an Organized Health Care Education/Training Program 2025 E. 7th Street, Long Beach, CA 90804 2015-09-15
1487059010 Kenenth K. Lee, D.d.s., Inc. Preferred Provider Organization 4755 E. Anaheim St., Long Beach, CA 90804 2014-10-24
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Taxonomy Information

Taxonomy Code 167G00000X
Grouping Nursing Service Providers
Classification Licensed Psychiatric Technician

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821450016 Ryann Thibodeaux Licensed Psychiatric Technician 2385 Easy Ave, Long Beach, CA 90810-3334 2016-03-25
1417047069 Anthony Desanto-kelly Licensed Psychiatric Technician 3501 N Lakewood Blvd, Long Beach, CA 90808-1736 2006-10-13
1730793563 Perla Hernandez Licensed Psychiatric Technician 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 2020-08-31
1740893916 Lisa Louise Morrison Licensed Psychiatric Technician 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 2020-08-27
1114539921 Maria Barnes Licensed Psychiatric Technician 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 2020-08-21
1831701267 Craig Alexander March Licensed Psychiatric Technician 1501 Hughes Way Ste 100, Long Beach, CA 90810-1877 2020-08-18
1548878606 Alejandro Chavira Licensed Psychiatric Technician 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 2020-07-15
1235773045 Parchae Heard Licensed Psychiatric Technician 456 Elm Ave, Long Beach, CA 90802-2426 2019-11-05
1962044206 Davinesha Marie Sally Licensed Psychiatric Technician 1775 Chestnut Ave, Long Beach, CA 90813-1674 2019-10-08
1295388684 Vincent Lopez Licensed Psychiatric Technician 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 2019-07-24
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Competitor

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City LONG BEACH
Zip Code 90804

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Dataset Information

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.

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