ELIZABETH ANNE DEGRAVIO (NPI# 1497167530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497167530 |
Entity Type | Individual |
Full Name | ELIZABETH ANNE DEGRAVIO |
Practice Address |
10904 Lands End Dr Stockton CA 95209-4289 |
Practice Telephone | 2099865996 |
Mailing Telephone | 2099865996 |
Enumeration Date | 2014-05-23 |
Last Update Date | 2014-05-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 167G00000X | Licensed Psychiatric Technician | 37500 | CA | Nursing Service Providers |
Street Address |
10904 LANDS END DR |
City | STOCKTON |
State | CA |
Zip Code | 95209-4289 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104272954 | William Luther Bennett | Pharmacist | 1131 Sunnyoak Way, Stockton, CA 95209 | 2016-05-11 |
1548686769 | Roland Rillamas Lagpacan | Pharmacist | 3131 West Hammer Lane, Stockton, CA 95209 | 2014-03-12 |
1346599677 | Luis Leyva Garcia | Marriage & Family Therapist | 1755 West Hammer Lane, Stockton, CA 95209 | 2012-08-31 |
1942506233 | Donna Lynn Peterson | Dentist | 9409 Thornton Rd, Stockton, CA 95209 | 2011-02-03 |
1386969798 | Miusotic Zaragoza | Social Worker | 1755 W. Hammer Lane Suite 8, Latino Behavioral Health, Stockton, CA 95209 | 2010-03-30 |
1497988844 | Marissa Elizabeth Preciado | Counselor | 10147 River Falls Cir, Stockton, CA 95209 | 2009-09-02 |
1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
1881845790 | Gary Earl Fiscus | Dentist | 4565 Quail Lakes Drive, Suite A-2, Stockton, CA 95209 | 2008-10-09 |
1326225665 | Shirley's Care Home Inc | Intermediate Care Facility, Mentally Retarded | 2330 Shropshire Dr, Stockton, CA 95209 | 2008-01-29 |
1134272727 | Joanie Mc Culloch | Homeopath | 8807 Thornton Rd, Ste. P, Stockton, CA 95209 | 2007-01-19 |
Find all providers in zip 95209 |
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 |
---|---|---|---|---|
1114530250 | Heather Elizabeth Phillips | Licensed Psychiatric Technician | 4900 N Highway 99 Unit 68, Stockton, CA 95212-1007 | 2020-08-28 |
1093337511 | Christine Ann Scheuermann | Licensed Psychiatric Technician | 1447 Report Ave, Stockton, CA 95205-3030 | 2020-05-07 |
1609336882 | Monica Fuentes-rodriguez | Licensed Psychiatric Technician | 7000 N Michael Canlis Blv, Stockton, CA 95206 | 2019-03-22 |
1801215082 | Ashlee Nicole Torres | Licensed Psychiatric Technician | 231 E Bianchi Rd, Stockton, CA 95207-7430 | 2014-04-15 |
1366884058 | Jill Siador | Licensed Psychiatric Technician | 3731 Carly Dr, Stockton, CA 95205-2589 | 2013-07-23 |
1477809929 | Milagros Moreno Mcarthur | Licensed Psychiatric Technician | 10834 Copperopolis Rd, Stockton, CA 95215-1741 | 2012-08-01 |
1033485495 | Thuy Huynh | Licensed Psychiatric Technician | 4545 Georgetown Place Suite A3, Stockton, CA 95207 | 2012-03-29 |
1124232665 | Lyndsey Marie Socha | Licensed Psychiatric Technician | 1947 N California St Ste C, Stockton, CA 95204-6029 | 2007-05-10 |
1851515092 | Barbara Franklin | Licensed Psychiatric Technician | 4514 Mcgaw St Apt 2, Stockton, CA 95207-8119 | 2007-04-12 |
1881817567 | Dolfa Lirazan Magsayo | Licensed Psychiatric Technician | 3019 Fairbury Ln, Stockton, CA 95206-6031 | 2007-04-11 |
Find all providers in STOCKTON |
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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.