Fejiro Elo Okumo

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT43404 Issued in CA

Practice address

2101 Courage Dr
Fairfield, CA 94533-6717

Phone

(707) 428-1131

Fax

(707) 399-9170

NPI assigned

Oct 12, 2026

Last updated

Oct 12, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1538064357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 LEGION CT",
            "city": "DIXON",
            "state": "CA",
            "postal_code": "956209308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-428-1131",
            "fax_number": "707-399-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUMO",
        "first_name": "FEJIRO",
        "middle_name": "ELO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT43404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Psychiatric Technician in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.