Michelle Carol Alejandrez

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT36797 Issued in CA

Practice address

142 W 5TH St Apt 7
San Dimas, CA 91773-2155

Phone

(626) 696-0028

NPI assigned

Jun 16, 2013

Last updated

Feb 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Carol Asencio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1371340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1568801207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 W 5TH ST APT 7",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732155",
            "telephone_number": "626-696-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 W 5TH ST APT 7",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732155",
            "telephone_number": "626-696-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEJANDREZ",
        "first_name": "MICHELLE",
        "middle_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-16",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT36797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ASENCIO",
            "middle_name": "CAROL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Psychiatric Technician in San Dimas, CA
• Providers in San Dimas, 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 Feb 10, 2015; 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.