Bruce Baughman
Individual provider Active NPI Licensed Psychiatric Technician · Yucca Valley, CA
NPI 1083022016 · NPPES record last updated Jul 22, 2014
Key facts
- NPI
- 1083022016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Psychiatric Technician 167G00000X
- License
- 23466 (CA)
- Practice address
- 55475 Santa Fe TRL
Ste 100
Yucca Valley, CA 92284-3117 - Phone
- (855) 365-6558
- NPI assigned
- Jul 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 23466 | CA | Yes |
Addresses
Primary practice location
55475 Santa Fe TRL
Ste 100
Yucca Valley, CA 92284-3117
Mailing address
55475 Santa Fe TRL
Ste 100
Yucca Valley, CA 92284-3117
Phone (855) 365-6558
Other providers in Yucca Valley, CA
- Itzia Adilene Basulto Montes
- Quincy Jean Bates
- John Batin
- Mariah Batin
- Leevan Reyes Bauer
- Kristen Emma Beamer
- Salvatore J. Bearse
- Robin M Belle
- Jacqueline Berrios
- Daniell Lynn Berry
All providers in Yucca Valley, CA · Licensed Psychiatric Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.