Brian Rick Atwell Sr., PT

Individual provider Active NPI Licensed Psychiatric Technician · Atascadero, CA

NPI 1457546673 · NPPES record last updated Jun 23, 2024

Key facts

NPI
1457546673
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Psychiatric Technician 167G00000X
License
PT28932 (CA)
Practice address
6500 Morro Rd
Atascadero, CA 93422-4142
Phone
(805) 461-5212
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT28932CAMDLicensed Psychiatric Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X PT28932 CA Yes

Addresses

Primary practice location

6500 Morro Rd
Atascadero, CA 93422-4142

Mailing address

7246 Remmet Ave
Canoga Park, CA 91303-1531
Phone (818) 206-0360

Other providers in Atascadero, CA

All providers in Atascadero, CA · Licensed Psychiatric Technician in California

Sources for this page

Verify at the official NPI Registry.