ODUBANKE YEWANDE MCGAUGH (NPI# 1699258392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699258392 |
| Entity Type | Individual |
| Full Name | ODUBANKE YEWANDE MCGAUGH |
| Practice Address |
4612 Roosevelt Ave Sacramento CA 95820-4520 |
| Mailing Address |
18525 Sutter Blvd Ste 200 Morgan Hill CA 95037-2899 |
| Practice Telephone | 9163795876 |
| Mailing Telephone | 4084658280 |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2020-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 41707 | CA | Nursing Service Providers |
| Street Address |
4612 ROOSEVELT AVE |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95820-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265455893 | Melissa Vanteslaar | Marriage & Family Therapist | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2006-07-25 |
| 1497362057 | Liana Loren Perez | Licensed Vocational Nurse | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2020-09-28 |
| 1811502040 | Maddysen Casimir-taylor | Counselor | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2020-09-14 |
| 1316557465 | Bintu Sia Sorie | Licensed Psychiatric Technician | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2020-08-04 |
| 1770101735 | Sheryll Pragasa | Counselor | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2020-07-07 |
| 1326679812 | Tia Dalipe | Technician, Pathology | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2020-02-03 |
| 1962062844 | Ashley A Vicens | Licensed Vocational Nurse | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2019-06-13 |
| 1528553062 | Allen Christopher Mendoza | Licensed Vocational Nurse | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2018-06-27 |
| 1558854158 | Laura Jeanne Bishop | Counselor | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2018-06-08 |
| 1043728256 | Celeste Lomeli | Counselor | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2018-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676820 | Laraine K Koen | Student in an Organized Health Care Education/Training Program | 123 Brookshire Lane, Sacramento, CA 95820 | 2020-10-12 |
| 1730737727 | Vincent Tang | Student in an Organized Health Care Education/Training Program | 3230 Sher Court, Sacramento, CA 95820 | 2019-09-03 |
| 1871159897 | Lauren Smith | Student in an Organized Health Care Education/Training Program | Department of Pediatrics Uc Davis Children's Hospital, 3671 Business Dr. Suite #110, Sacramento, CA 95820 | 2019-05-15 |
| 1053899336 | Melissa Anne Jeffery | Community Health Worker | 4600 Broadway Suite 1300, Sacramento, CA 95820 | 2018-07-30 |
| 1841785284 | Chelsea Kirstin Acker | Student in an Organized Health Care Education/Training Program | 3671 Business Dr., Sacramento, CA 95820 | 2018-06-28 |
| 1770022667 | Shelly Valdez | Behavior Technician | 5520 Priscilla Ln, Sacramento, CA 95820 | 2017-02-13 |
| 1285184135 | Trang Thu Tran | Registered Nurse | 5385 Franklin Blvd Ste A-d, Sacramento, CA 95820 | 2016-10-04 |
| 1356716039 | Nicole Hisaka | Psychologist | 3651 Business Dr, Sacramento, CA 95820 | 2015-12-07 |
| 1538542469 | Universal Med Express, LLC | Non-emergency Medical Transport (VAN) | 3230 27th Ave, Sacramento, CA 95820 | 2015-07-09 |
| 1033507470 | Moua Yang | Case Manager/Care Coordinator | 7373 14th Ave, Suite 120-b, Sacramento, CA 95820 | 2015-01-08 |
| Find all providers in zip 95820 | ||||
| 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 |
|---|---|---|---|---|
| 1245374966 | Kathy Mary Simms | Licensed Psychiatric Technician | 6615 Valley Hi Dr # A, Sacramento, CA 95823-4601 | 2007-02-16 |
| 1609972223 | Sallyann Smith | Licensed Psychiatric Technician | 9337 Heathfield Way, Sacramento, CA 95829-6081 | 2006-09-15 |
| 1811090723 | Elizabeth Ann Hayes | Licensed Psychiatric Technician | 811 Grand Ave Suite D, Sacramento, CA 95822-3466 | 2006-09-06 |
| 1275644718 | Levi Aaron Combs | Licensed Psychiatric Technician | 2045 W El Camino Ave Apt 455, Sacramento, CA 95833-1481 | 2006-08-31 |
| 1558384321 | Joseph Warren Gibbs | Licensed Psychiatric Technician | 8036 Center Pkwy, Sacramento, CA 95823-5243 | 2006-07-25 |
| 1356940159 | Hadia N Khalil | Licensed Psychiatric Technician | 401 S St, Sacramento, CA 95811-6919 | 2020-10-22 |
| 1316557465 | Bintu Sia Sorie | Licensed Psychiatric Technician | 4612 Roosevelt Ave, Sacramento, CA 95820-4520 | 2020-08-04 |
| 1770119893 | Crystal D Washington | Licensed Psychiatric Technician | 1103 N B St Ste E, Sacramento, CA 95811-0326 | 2020-03-20 |
| 1023659182 | Theresa Ann Jordan | Licensed Psychiatric Technician | 6950 65th St, Sacramento, CA 95823-2316 | 2019-09-30 |
| 1396394490 | Princess Jarrell | Licensed Psychiatric Technician | 3815 Marconi Ave, Sacramento, CA 95821-3867 | 2019-09-10 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95820 |
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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.