Maija Thackerson, L.P.T.

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT 16398 Issued in CA

Practice address

4151 E Fountain St
Long Beach, CA 90804-3023

Phone

(562) 719-9250

Fax

(562) 719-9261

NPI assigned

Jun 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1346502218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 E FOUNTAIN ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 E FOUNTAIN ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043023",
            "telephone_number": "562-719-9250",
            "fax_number": "562-719-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKERSON",
        "first_name": "MAIJA",
        "credential": "L.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT 16398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Bellocchio Tessina, MFT 13629
• Lori L Teves
• Michael A. Tevosian, D.O.
• Chinda Thach
• Darlena Thach, FNP-C
• Alison H Thai, PHARMD
• Marlin Thai, PHARM.D.
• Nam Khanh Thai, MD
• Bhavik V Thakkar, MD
• Gregory Lee Thalken, MD

• Licensed Psychiatric Technician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.