Individual provider Active NPI

Dawn Stockhausen

  • Licensed Psychiatric Technician
  • Yucca Valley, CA
National Provider Identifier
1497151054
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
PT37826 Issued in CA
Practice address
58945 Business Center Dr
Yucca Valley, CA 92284-7307
Phone
(760) 369-4015
NPI assigned
Nov 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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 PT37826 CA Primary

Addresses

Primary practice location

58945 Business Center Dr
Yucca Valley, CA 92284-7307

Mailing address

1316 S Meadow LN Apt 265
Colton, CA 92324-6427
Phone (909) 532-4198

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
PT37826CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1497151054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 S MEADOW LN APT 265",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923246427",
            "telephone_number": "909-532-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58945 BUSINESS CENTER DR",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847307",
            "telephone_number": "760-369-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKHAUSEN",
        "first_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT37826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.