Active NPI
Jeramy Bernard Summers, LPT
- Licensed Psychiatric Technician
- Vallejo, CA
National Provider Identifier
1306669429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 42359
- Practice address
- 314 12TH St
Vallejo, CA 94590-6469 - Phone
- (415) 503-7812
- NPI assigned
- Nov 6, 2024
- Last updated
- Nov 6, 2024
- 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 | 42359 | CA | Primary |
Addresses
Primary practice location
314 12TH St
Vallejo, CA 94590-6469
Mailing address
314 12TH St
Vallejo, CA 94590-6469
Phone (415) 503-7812
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 |
|---|---|---|---|
| 42359 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1306669429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 12TH ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945906469",
"telephone_number": "415-503-7812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 12TH ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945906469",
"telephone_number": "415-503-7812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "JERAMY",
"middle_name": "BERNARD",
"credential": "LPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-06",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "42359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.