Victoria Lynn Broussard in Baldwin Park - Licensed Psychiatric Technician
Victoria Lynn Broussard - NPI 1770624090
Victoria Lynn Broussard is a Licensed Psychiatric Technician in Baldwin Park, California. Victoria Lynn Broussard practices all healthcare services and medical treatments related to Licensed Psychiatric Technician. The NPI Number for Victoria Lynn Broussard is 1770624090. The last update date is 2007-07-08.
Victoria Lynn Broussard's current location address is 4600 Bresee Ave, Baldwin Park, California. You can contact this provider via phone number 6263370747. The mailing address for Victoria Lynn Broussard is 4600 Bresee Ave, Baldwin Park, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Victoria Lynn Broussard |
|---|---|
| Address | 4600 Bresee Ave, Baldwin Park, California |
| Phone Number | 6263370747 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LPT |
NPI Number Detail
| NPI Number | 1770624090 |
|---|---|
| Provider Enumeration Date | 2007-02-09 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4600 Bresee Ave |
|---|---|
| City | Baldwin Park |
| State | California (CA) |
| Post Code | 917062414 |
| Phone Number | 6263370747 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Licensed Psychiatric Technician |
|---|---|
| Taxonomy | 167G00000X |
| Licence No | 19904 |
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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 psych |
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What is the unique provider identifier assigned to Victoria Lynn Broussard?
The Victoria Lynn Broussard has been issued the NPI (National Provider Identifier) 1770624090 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Victoria Lynn Broussard's physical address?
The Victoria Lynn Broussard is physically located at 4600 Bresee Ave, in the city of Baldwin Park, CA, with the postal code 917062414.
What is Victoria Lynn Broussard's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Victoria Lynn Broussard is Licensed Psychiatric Technician, and the taxonomy code that classifies this field of practice is 167G00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1770624090 to Victoria Lynn Broussard?
The Centers for Medicare & Medicaid Services assigned the 1770624090 to Victoria Lynn Broussard on 2007-02-09.
When was the information pertaining to Victoria Lynn Broussard most recently updated or revised?
The details related to Victoria Lynn Broussard, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.