Kenneth John Peralta Sanga

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT36258 Issued in CA

Practice address

14659 Olive View Dr
Sylmar, CA 91342-1652

Phone

(818) 485-0888

Fax

(818) 833-5690

NPI assigned

Oct 26, 2015

Last updated

Oct 26, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1114399581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14659 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421652",
            "telephone_number": "818-485-0888",
            "fax_number": "818-833-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14659 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421652",
            "telephone_number": "818-485-0888",
            "fax_number": "818-833-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGA",
        "first_name": "KENNETH JOHN",
        "middle_name": "PERALTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT36258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisette Sanchez
• Jaskaran Singh Sandhu
• Carminia Marie Zablan Sandico
• Kayla Aleece Sandoval
• Patricia Alondra Sandoval, MSW
• Caryn Gyzel Santiago, ANP
• Itzhel Santiago
• Duke Santos
• Sarai Genesis Santos, MD
• Paula Indrayany Saputra, PHARM.D.

• Licensed Psychiatric Technician in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.