Active NPI
David Adolfo Coloma, LPT
- Licensed Psychiatric Technician
- Norwalk, CA
National Provider Identifier
1477639946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- Practice address
- 12353 Imperial Hwy
Apt. #1
Norwalk, CA 90650 - Phone
- (562) 484-3385
- Fax
- (562) 484-0269
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | PT30173 | CA | |
| Licensed Psychiatric Technician | 167G00000X | Primary |
Addresses
Primary practice location
12353 Imperial Hwy
Apt. #1
Norwalk, CA 90650
Mailing address
12353 Imperial Hwy
Norwalk, CA 90650
Phone (562) 484-3385
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 |
|---|---|---|---|
| PT30173 | CA | MD | Licensed Psychiatric Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telecare Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Valley Vista Permanent Supportive Housing
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- NPI 1275398935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1477639946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12353 IMPERIAL HWY",
"city": "NORWALK",
"state": "CA",
"postal_code": "90650",
"telephone_number": "562-484-3385",
"fax_number": "562-484-0269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12353 IMPERIAL HWY",
"address_2": "APT. #1",
"city": "NORWALK",
"state": "CA",
"postal_code": "90650",
"telephone_number": "562-484-3385",
"fax_number": "562-484-0269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLOMA",
"first_name": "DAVID",
"middle_name": "ADOLFO",
"name_prefix": "Mr.",
"credential": "LPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "PT30173",
"primary": false
},
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.