Active NPI
Timothy Alan Lundgren, LPT
- Licensed Psychiatric Technician
- Pasadena, CA
National Provider Identifier
1023382769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 36282
- Practice address
- 1020 S Arroyo Pkwy
Pasadena, CA 91105-3911 - Phone
- (626) 294-1079
- NPI assigned
- Feb 27, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 36282 | CA | Primary |
Addresses
Primary practice location
1020 S Arroyo Pkwy
Pasadena, CA 91105-3911
Mailing address
713 Gaillard St
La Verne, CA 91750-3827
Phone (909) 217-8871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1023382769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 GAILLARD ST",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917503827",
"telephone_number": "909-217-8871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 S ARROYO PKWY",
"city": "PASADENA",
"state": "CA",
"postal_code": "911053911",
"telephone_number": "626-294-1079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDGREN",
"first_name": "TIMOTHY",
"middle_name": "ALAN",
"credential": "LPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-27",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "36282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.