Active NPI
John Gibson
- Licensed Psychiatric Technician
- Long Beach, CA
National Provider Identifier
1114190667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- PT23156
- Practice address
- 1775 Chestnut Ave
Long Beach, CA 90813-1674 - Phone
- (310) 707-4318
- Fax
- (000) 000-0000
- NPI assigned
- Apr 4, 2008
- Sex
- Male
- Sole proprietor
- No
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 | PT23156 | CA | Primary |
Addresses
Primary practice location
1775 Chestnut Ave
Long Beach, CA 90813-1674
Mailing address
4735 Hayter Ave
Lakewood, CA 90712-3508
Phone (562) 756-7546
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT23156 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1114190667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4735 HAYTER AVE",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907123508",
"telephone_number": "562-756-7546",
"fax_number": "000-000-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 CHESTNUT AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908131674",
"telephone_number": "310-707-4318",
"fax_number": "000-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-04",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "PT23156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.