MR. ANTHONY DESANTO-KELLY (NPI# 1417047069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417047069 |
| Entity Type | Individual |
| Full Name | MR. ANTHONY DESANTO-KELLY |
| Credential | LICENSE PYSCH TECH 3 |
| Practice Address |
3501 N Lakewood Blvd Long Beach CA 90808-1736 |
| Mailing Address |
12857 Frederick St Apt 304 Moreno Valley CA 92553-4502 |
| Practice Telephone | 5625707119 |
| Mailing Telephone | 9516533141 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT24452 | CA | Nursing Service Providers |
| Street Address |
3501 N LAKEWOOD BLVD |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90808-1736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629558713 | Long Beach-lakewood Orthopedic Institute | Orthopaedic Surgery | 3828 Schaufele Ave Ste 320, Long Beach, CA 90808 | 2018-08-17 |
| 1376072710 | Premiere Cottages Inc. | Assisted Living Facility | 4815 Premiere Ave, Long Beach, CA 90808 | 2017-06-08 |
| 1760911184 | Collaborative Partners for Success, LLC | Speech-Language Pathologist | 3472 Tulane Avenue, Long Beach, CA 90808 | 2017-06-08 |
| 1942658604 | Susan S Orr | Physical Therapist | 3833 Worsham Ave #301, Long Beach, CA 90808 | 2016-06-02 |
| 1447611298 | Rac Brittany House | Alzheimer Center (Dementia Center) | 5641 Centralia Avenue, Long Beach, CA 90808 | 2016-03-08 |
| 1003234261 | Ray Ira Apter | Social Worker | 4333 N. Greenbrier Road, Long Beach, CA 90808 | 2014-04-03 |
| 1043590649 | Fonda Jiang | Allergy & Immunology | 3816 Woodruff Ave Ste 209, Long Beach, CA 90808 | 2011-08-26 |
| 1457640757 | Alexander Cristian Gavrila | Dentist | 4200 Lakewood Blvd, Long Beach, CA 90808 | 2011-04-07 |
| 1851629034 | Reyana Ewing | Dietitian, Registered | 4195 N Viking Way Ste D, Long Beach, CA 90808 | 2009-11-25 |
| 1548497597 | Veronika Lee Hoover | Social Worker | 4195 N. Viking Way, Suite F, Long Beach, CA 90808 | 2009-06-17 |
| Find all providers in zip 90808 | ||||
| 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 |
|---|---|---|---|---|
| 1821450016 | Ryann Thibodeaux | Licensed Psychiatric Technician | 2385 Easy Ave, Long Beach, CA 90810-3334 | 2016-03-25 |
| 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 |
| 1861957029 | Nicholas Saracho | Licensed Psychiatric Technician | 456 Elm Ave, Long Beach, CA 90802-2426 | 2019-02-01 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90808 |
Please comment or provide details below to improve the information on MR. ANTHONY DESANTO-KELLY.
| 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.