Individual provider Active NPI

Ingrid Azucena Vonjo, PT

  • Licensed Psychiatric Technician
  • Pico Rivera, CA
National Provider Identifier
1427363555
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
PT35093 Issued in CA
Practice address
9140 Whittier Blvd
Pico Rivera, CA 90660-2444
Phone
(562) 801-4626
Fax
(562) 801-4630
NPI assigned
Aug 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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 PT35093 CA Primary

Addresses

Primary practice location

9140 Whittier Blvd
Pico Rivera, CA 90660-2444

Mailing address

9140 Whittier Blvd
Pico Rivera, CA 90660-2444
Phone (562) 801-4626

Other names 1

  • Ingrid Azucena Contreras Former name

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
PT35093CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1427363555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602444",
            "telephone_number": "562-801-4626",
            "fax_number": "562-801-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9140 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602444",
            "telephone_number": "562-801-4626",
            "fax_number": "562-801-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONJO",
        "first_name": "INGRID",
        "middle_name": "AZUCENA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT35093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INGRID",
            "last_name": "CONTRERAS",
            "middle_name": "AZUCENA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.