Individual provider Active NPI

Christina Nampudakam

  • Licensed Psychiatric Technician
  • Santa Rosa, CA
National Provider Identifier
1336057207
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
PT40500 Issued in CA
Practice address
790 Sonoma Ave
Santa Rosa, CA 95404-4713
Phone
(707) 544-3295
NPI assigned
Aug 31, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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 PT40500 CA Primary

Addresses

Primary practice location

790 Sonoma Ave
Santa Rosa, CA 95404-4713

Mailing address

790 Sonoma Ave
Santa Rosa, CA 95404-4713
Phone (707) 544-3295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1336057207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 SONOMA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044713",
            "telephone_number": "707-544-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 SONOMA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044713",
            "telephone_number": "707-544-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMPUDAKAM",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT40500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.