Individual provider Active NPI

Jerod Paul Haskins, LPT

  • Licensed Psychiatric Technician
  • Morgan Hill, CA
National Provider Identifier
1225317787
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
35968 Issued in CA
Practice address
18217 Hale Ave
Morgan Hill, CA 95037-3550
Phone
(408) 465-8280
Fax
(408) 465-8281
NPI assigned
Aug 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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 35968 CA Primary

Addresses

Primary practice location

18217 Hale Ave
Morgan Hill, CA 95037-3550

Mailing address

18217 Hale Ave
Morgan Hill, CA 95037-3550
Phone (408) 465-8280

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
35968CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1225317787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18217 HALE AVE",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950373550",
            "telephone_number": "408-465-8280",
            "fax_number": "408-465-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18217 HALE AVE",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950373550",
            "telephone_number": "408-465-8280",
            "fax_number": "408-465-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKINS",
        "first_name": "JEROD",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "35968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.