Active NPI
Ethan Heap Hem
- Licensed Psychiatric Technician
- Orange, CA
National Provider Identifier
1396499539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 37736
- Practice address
- 265 S Anita Dr
Orange, CA 92868-3355 - Phone
- (949) 749-2500
- NPI assigned
- Feb 7, 2022
- 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 | 37736 | CA | Primary |
Addresses
Primary practice location
265 S Anita Dr
Orange, CA 92868-3355
Mailing address
265 S Anita Dr
Orange, CA 92868-3355
Phone (949) 749-2500
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 |
|---|---|---|---|
| 37736 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1396499539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 S ANITA DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683355",
"telephone_number": "949-749-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 S ANITA DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683355",
"telephone_number": "949-749-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEM",
"first_name": "ETHAN",
"middle_name": "HEAP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-07",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "37736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.