CEVIN JORDAN WHITE O'HAGAN


Address: 303 Potrero St Ste 304, Santa Cruz, CA 95060-2741
Phone: 8314200120

CEVIN JORDAN WHITE O'HAGAN (NPI# 1730318114) 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) 1730318114
Entity Type Individual
Full Name CEVIN JORDAN WHITE O'HAGAN
Credential LPT
Practice Address 303 Potrero St Ste 304
Santa Cruz
CA 95060-2741
Mailing Address 303 Potrero St Ste 42-103
Santa Cruz
CA 95060-2779
Practice Telephone 8314200120
Practice Fax Number 8314201057
Mailing Telephone 8314200120
Mailing Fax Number 8314201057
Enumeration Date 2009-07-07
Last Update Date 2009-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 167G00000X Licensed Psychiatric Technician 33563 CA Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA MEDI-CAL PRV NBR 44AV 01

Office Location

Street Address 303 POTRERO ST STE 304
City SANTA CRUZ
State CA
Zip Code 95060-2741

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366940215 Tiphanie Bowens Counselor 380 Encinal St., Suite 200, Santa Cruz, CA 95060 2018-01-25
1942714167 Kyle Hardwick Chiropractor 203 River Street, Santa Cruz, CA 95060 2017-11-27
1972015741 Nina Marie Francesconi Acupuncturist 110 Fern St Apt. C, Santa Cruz, CA 95060 2017-11-01
1679091870 Laura Evelyn Rochelle Counselor 380 Encinal St., Suit 200, Santa Cruz, CA 95060 2017-09-07
1649797903 Jessica Tarnoff Counselor 716 Ocean St., Santa Cruz, CA 95060 2017-08-28
1356862064 Lakia Niema Queen Counselor 542 Ocean Street Suite K, Santa Cruz, CA 95060 2017-07-03
1023555992 Allison Whitehead Nurse Practitioner 1080 Emeline Ave., County of Santa Cruz Health Services Agency, Santa Cruz, CA 95060 2017-01-30
1659827293 Annabelle Drda Marriage & Family Therapist 303 Portero St, Santa Cruz, CA 95060 2016-09-01
1376999698 Erin Liana Johnson Counselor 104 Walnut Avenue, Suite 208, Santa Cruz, CA 95060 2016-05-05
1659732097 Daniel Ezekiel Contreras Counselor 1080 Emeline Building D, Santa Cruz, CA 95060 2016-03-13
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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
1265096333 Brenda Patricia Gonzales Licensed Psychiatric Technician 2250 Soquel Ave, Santa Cruz, CA 95062-1402 2019-04-24
1952854937 Elvie Goddard Licensed Psychiatric Technician 2250 Soquel Ave, Suite 100, Santa Cruz, CA 95062-1402 2016-07-26
1134581978 Matt Craven Licensed Psychiatric Technician 2250 Soquel Ave, Ste 100, Santa Cruz, CA 95062-1402 2016-03-22
1528499704 Laura Milosevich Licensed Psychiatric Technician 2250 Soquel Ave Ste 150, Santa Cruz, CA 95062-1402 2013-12-12
1366789646 Kyle Thomas Anderson Licensed Psychiatric Technician 2115 7th Ave, Santa Cruz, CA 95062-1663 2013-01-07
1740487990 William Tamoshaitis Licensed Psychiatric Technician 1400 Emeline Ave, Santa Cruz, CA 95060-1976 2007-06-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982203592 Leahann Vedella Licensed Psychiatric Technician 2398 Flatley Cir, Fairfield, CA 94533-8921 2020-10-23
1225635865 Thalia I. Rochel Licensed Psychiatric Technician 450 E Temple St, Los Angeles, CA 90012-4022 2020-10-06
1427665090 Egbert Tantiongco Licensed Psychiatric Technician 1460 E Willow St, Signal Hill, CA 90755-3549 2020-09-28
1114530250 Heather Elizabeth Phillips Licensed Psychiatric Technician 4900 N Highway 99 Unit 68, Stockton, CA 95212-1007 2020-08-28
1841801479 Mercedes Samantha Hamilton Licensed Psychiatric Technician 18465 Grand Ave, Lake Elsinore, CA 92530 2020-08-17
1609491935 Elisa Becerra Licensed Psychiatric Technician 745 Park St, Paso Robles, CA 93446-2834 2020-06-12
1518581099 Theresa Lynn Stewart Licensed Psychiatric Technician 1110 Newport Way, Roseville, CA 95661-5315 2020-06-01
1093337511 Christine Ann Scheuermann Licensed Psychiatric Technician 1447 Report Ave, Stockton, CA 95205-3030 2020-05-07
1477189512 Sandra J Foshee Licensed Psychiatric Technician 48918 Mojave Dr, Morongo Valley, CA 92256-9243 2020-03-20
1376177725 Chanel Christine Turpin Licensed Psychiatric Technician 450 Kings County Dr Ste 102, Hanford, CA 93230-5782 2020-02-25
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Competitor

Search similar providers

City SANTA CRUZ
Zip Code 95060

Improve Information

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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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