Individual provider Active NPI

Marc Aaron Scharbrough, LPT

  • Licensed Psychiatric Technician
  • Sacramento, CA
National Provider Identifier
1124304811
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
361200 Issued in CA
Practice address
900 Fulton Ave Ste 205
Sacramento, CA 95825-4517
Phone
(916) 484-3570
Fax
(916) 484-3577
NPI assigned
Oct 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X 361200 CA Primary

Addresses

Primary practice location

900 Fulton Ave Ste 205
Sacramento, CA 95825-4517

Mailing address

5752 Mendocino Blvd
Sacramento, CA 95824-1212
Phone (530) 282-8264

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

LicenseStateTypeSpecialty
361200CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1124304811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5752 MENDOCINO BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958241212",
            "telephone_number": "530-282-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FULTON AVE STE 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254517",
            "telephone_number": "916-484-3570",
            "fax_number": "916-484-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHARBROUGH",
        "first_name": "MARC",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "361200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.