ELIZABETH ANNE DEGRAVIO


Address: 10904 Lands End Dr, Stockton, CA 95209-4289
Phone: 2099865996

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 167G00000X Licensed Psychiatric Technician 37500 CA Nursing Service Providers

Office Location

Street Address 10904 LANDS END DR
City STOCKTON
State CA
Zip Code 95209-4289

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NPI Name Taxonomy Address Enumeration
1104272954 William Luther Bennett Pharmacist 1131 Sunnyoak Way, Stockton, CA 95209 2016-05-11
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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
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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
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
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Competitor

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City STOCKTON
Zip Code 95209

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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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