Individual provider Active NPI

Julius Laguna Peralta

  • Licensed Psychiatric Technician
  • San Jose, CA
National Provider Identifier
1356848774
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
29397 Issued in CA
Practice address
2001 The Alameda
San Jose, CA 95126-1136
Phone
(408) 261-7777
Fax
(408) 259-2273
NPI assigned
Apr 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 167G00000X 29397 CA Primary

Addresses

Primary practice location

2001 The Alameda
San Jose, CA 95126-1136

Mailing address

2530 Harlow LN
San Ramon, CA 94582-5795
Phone (925) 575-4931

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
29397CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1356848774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 HARLOW LN",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945825795",
            "telephone_number": "925-575-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "JULIUS",
        "middle_name": "LAGUNA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "29397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.