Active NPI
Misti D Palmer, LPT
- Licensed Psychiatric Technician
- Rancho Cucamonga, CA
National Provider Identifier
1154626232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- PT 35030
- Practice address
- 9047 Arrow Rte
Rancho Cucamonga, CA 91730-4449 - Phone
- (909) 466-8696
- NPI assigned
- Jan 20, 2011
- Sex
- Female
- 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 | PT 35030 | CA | Primary |
Addresses
Primary practice location
9047 Arrow Rte
Rancho Cucamonga, CA 91730-4449
Mailing address
11305 Bellegrave Ave
Mira Loma, CA 91752-1602
Phone (909) 263-9716
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 35030 | Other | CA | BOARD OF VOCATIONAL NURSES AND PSYCHIATRIC TECHNICIANS |
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 |
|---|---|---|---|
| PT 35030 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1154626232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11305 BELLEGRAVE AVE",
"city": "MIRA LOMA",
"state": "CA",
"postal_code": "917521602",
"telephone_number": "909-263-9716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9047 ARROW RTE",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917304449",
"telephone_number": "909-466-8696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "MISTI",
"middle_name": "D",
"credential": "LPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-20",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "PT 35030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF VOCATIONAL NURSES AND PSYCHIATRIC TECHNICIANS",
"identifier": "PT 35030",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.