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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 167G00000X | Licensed Psychiatric Technician | 33563 | CA | Nursing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDI-CAL PRV NBR | 44AV | 01 |
Street Address |
303 POTRERO ST STE 304 |
City | SANTA CRUZ |
State | CA |
Zip Code | 95060-2741 |
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 |
Find all providers in zip 95060 |
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 |
---|---|---|---|---|
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 |
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 |
Find all providers with the same taxonomy |
City | SANTA CRUZ |
Zip Code | 95060 |
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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.